scholarly journals A Novel and Severe Clinical Picture Related to COVID-19: Multi-Inflammatory Syndrome in Children

2021 ◽  
Author(s):  
Fatih Haşlak ◽  
Mehmet Yıldız ◽  
Sezgin Şahin ◽  
Amra Adrovic Yıldız ◽  
Kenan Barut ◽  
...  
Keyword(s):  
Macrophage Activation ◽  
Clinical Findings ◽  
Disease Course ◽  
Toxic Shock ◽  
Active Infection ◽  
Severe Clinical Picture ◽  
Life Threatening ◽  
History Of ◽  
Distinct Features ◽  
Inflammatory Syndrome

Preliminary data have suggested that children have milder COVID-19 disease course compared to adults. However, pediatric cases with severe clinical findings caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) are being reported since April 2020. These children have been presented with significant hyperinflammatory states resembling Kawasaki disease, toxic shock syndrome, and macrophage activation syndrome. However, they had several distinct features, as well. Therefore, this novel condition was considered a unique disease and named Multi-inflammatory syndrome in children (MIS-C). Thus, new concerns have been raised regarding the vulnerability of the children. However, it has been realized that this condition is extremely rare. Nonetheless, considering that it is a life-threatening disease and may cause devastating consequences, clinicians should be aware of MIS-C while evaluating children with persistent fever and history of COVID-19 contact or active infection.

scholarly journals SARS-CoV-2-Induced Multisystem Inflammatory Syndrome in a Young Adult: Case Report

2021 ◽  
Author(s):  
Haldun Bulut ◽  
Alexandra H. E. Herbers ◽  
Ilse M. G. Hageman ◽  
Paetrick M. Netten ◽  
Hendrik J. M. de Jonge ◽  
...  
Keyword(s):  
Macrophage Activation ◽  
Cardiac Involvement ◽  
Toxic Shock ◽  
Adult Case ◽  
Incomplete Kawasaki Disease ◽  
Volume Loading ◽  
Male Athlete ◽  
Life Threatening ◽  
Cardiac Status ◽  
Inflammatory Syndrome

AbstractWe describe a case of a previous healthy 20-year-old male athlete who presented with an atypical clinical profile with multiorgan involvement within five weeks after confirmed SARS-CoV-2 infection, suggestive for multisystem inflammatory syndrome (MIS); MIS is a rare, potentially life-threatening complication associated with SARS-CoV-2. MIS shares similar clinical features compatible with several overlapping lifethreatening hyperinflammatory syndromes, such as incomplete Kawasaki Disease (KD) and toxic shock syndrome (TSS) associated to a cytokine storm suggestive of a macrophage activation syndrome (MAS) without fulfilling the criteria for hemophagocytic lymphohistiocytosis (HLH), that may create a great challenge to distinguish between them. MIS should promptly be considered and treated, as uncontrolled MIS has a high mortality.In MIS cardiac involvement, heart failure may present as an additional problem, especially because volume loading is advised in accordance with proposed therapy. Carefully monitoring of the respiratory and cardiac status in response of resuscitation is therefore warranted.

scholarly journals A multisystem inflammatory syndrome in children associated with COVID-19 in a 11-years-old girl

2021 ◽  
pp. 78-78
Author(s):  
Milena Bjelica ◽  
Gordana Vilotijevic-Dautovic ◽  
Andrea Djuretic ◽  
Slobodan Spasojevic
Keyword(s):  
Gastrointestinal Symptoms ◽  
World Health ◽  
Nasopharyngeal Swab ◽  
First Case ◽  
Control And Prevention ◽  
Inflammatory State ◽  
Life Threatening ◽  
History Of ◽  
Health Organization ◽  
Inflammatory Syndrome

Introduction. Multisystem inflammatory syndrome in children (MIS-C) is a post-viral, life-threatening, inflammatory state with multisystem involvement that typically manifests 3-4 weeks after SARS-CoV-2 infection. In this article, we present the first case of MIS-C in the Institute for Child and Youth Health Care of Vojvodina at the beginning of the COVID-19 pandemic. Case outline. A previously 11-years-old healthy girl got sick two days before admission to the hospital with a fever, headache, vomiting, abdominal pain, and fatigue. She was tested positive for COVID-19 by nasopharyngeal swab PCR with positive IgM and IgG antibodies. In the further course the illness presented with prolonged fever, laboratory evidence of inflammation, multiorgan involvement such as respiratory, gastrointestinal, cardiovascular, and dermatologic. Based on Centers for Disease Control and Prevention and World Health Organization criteria the diagnosis of MIS-C was made and IVIG and methylprednisolone were introduced with favorable clinical course. Conclusion. Every prolonged and unusual febrile state, especially if it is accompanied by gastrointestinal symptoms, in a school-age child, should be investigated in the direction of recent COVID-19 infection or exposure. In a case of a positive COVID-19 history or history of exposure, the MIS-C diagnosis should be considered.

scholarly journals Distinct characteristics of multisystem inflammatory syndrome in children in Poland

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kamila Maria Ludwikowska ◽  
Magdalena Okarska-Napierała ◽  
Natalia Dudek ◽  
Paweł Tracewski ◽  
Jacek Kusa ◽  
...  
Keyword(s):  
Intensive Care ◽  
Macrophage Activation Syndrome ◽  
Macrophage Activation ◽  
Cardiac Involvement ◽  
Pediatric Intensive Care ◽  
Intensive Care Treatment ◽  
Disease Course ◽  
Specific Population ◽  
Inflammatory Syndrome ◽  
Activation Syndrome

AbstractDuring the winter months of 2020/2021 a wave of multisystem inflammatory syndrome in children (MIS-C) emerged in Poland. We present the results of a nationwide register aiming to capture and characterise MIS-C with a focus on severity determinants. The first MIS-C wave in Poland was notably high, hence our analysis involved 274 children. The group was 62.8% boys, with a median age of 8.8 years. Besides one Asian, all were White. Overall, the disease course was not as severe as in previous reports, however. Pediatric intensive care treatment was required for merely 23 (8.4%) of children, who were older and exhibited a distinguished clinical picture at hospital admission. We have also identified sex-dependent differences; teenage boys more often had cardiac involvement (decreased ejection fraction in 25.9% vs. 14.7%) and fulfilled macrophage activation syndrome definition (31.0% vs. 15.2%). Among all boys, those hospitalized in pediatric intensive care unit were significantly older (median 11.2 vs. 9.1 years). Henceforth, while ethnicity and sex may affect MIS-C phenotype, management protocols might be not universally applicable, and should rather be adjusted to the specific population.

scholarly journals Nosocomial Staphylococcal Toxic Shock. Case Report

2016 ◽  
Vol 2 (3) ◽  
pp. 142-144
Author(s):  
Manuela Arbune ◽  
Loredana Tercu
Keyword(s):  
Nitrogen Retention ◽  
Sudden Onset ◽  
Multiple Organ ◽  
Fluid Replacement ◽  
Biliary Colic ◽  
Toxic Shock ◽  
Lethal Infection ◽  
History Of ◽  
Staphylococcal Toxic Shock Syndrome ◽  
Inflammatory Syndrome

Abstract Staphylococcal toxic shock syndrome (STSS) is a rare, potentially lethal infection, with a clinical picture of multiple organ dysfunction and shock. The etiology is Staphylococcus aureus exotoxin, while enterotoxins act as superantigens. Most cases are identified in women using a vaginal tampon. A 51-year-old female, with a past medical history of biliary dyskinesia, presented in the emergency room complaining of sudden onset of abdominal pain, vomiting, headache, myalgia, and chills. The initial diagnosis was biliary colic and was treated parenterally with Amoxi-clavulanate and fluid replacement. Initially, progress was unsatisfactory. Four days after admission she developed a systemic inflammatory syndrome, diffuse rash, jaundice, oliguria, confusion, persistent hypotension and biological evidence of thrombocytopenia, nitrogen retention, and cholestasis. She was admitted to the intensive care unit. A gluteal phlegmon induced after intramuscular injections was identified and surgically treated. Blood bacteriological cultures were negative, though MRSA was isolated in phlegmon pus. A diagnosis of STSS was based on CDC criteria. The risks of similar infections could be prevented by limiting intramuscular treatments and monitoring invasive procedures.

scholarly journals Carbamazepine-Induced Toxic Epidermal Necrolysis Managed by Mobile Teledermatology in COVID-19 Pandemic in Rural Nepal

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Vikash Paudel ◽  
Deepa Chudal
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Community Health Center ◽  
Smart Phone ◽  
Skin Lesions ◽  
Clinical Findings ◽  
Clinical Impression ◽  
Symptomatic Management ◽  
Life Threatening ◽  
History Of ◽  
Rural Nepal

Toxic epidermal necrolysis is a life-threatening dermatological emergency with high mortality if not treated in time. Here we report a case of toxic epidermal necrolysis due to carbamazepine in rural Nepal in COVID-19 pandemic who was successfully treated with the help of mobile teledermatology. The clinical impression of toxic epidermal necrolysis was made from “WhatsApp” video calls using a smart phone. The supportive features were the history of starting of carbamazepine 2 weeks prior for seizure disorder, clinical findings in serial photographs of skin with 40 percent body surface area involvement of necrotic skin lesions and bulla, and involvement of oral mucosa and eyes. The patient was immediately asked to stop carbamazepine and was treated with intravenous fluids and systemic steroids along with symptomatic management. As the whole world was suffering from lockdown due to COVID-19 crisis, it was impossible for the rural area patient to visit a dermatologist. Thus, with the help of paramedics staff in a community health center and mobile teledermatology, the patient was diagnosed as carbamazepine-induced toxic epidermal necrolysis and treated successfully with good outcome.

scholarly journals Natural history of transient myeloproliferative disorder clinically diagnosed in Down syndrome neonates: a report from the Children's Oncology Group Study A2971

Blood ◽  
2011 ◽  
Vol 118 (26) ◽  
pp. 6752-6759 ◽  
Author(s):  
Alan S. Gamis ◽  
Todd A. Alonzo ◽  
Robert B. Gerbing ◽  
Joanne M. Hilden ◽  
April D. Sorrell ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Natural History ◽  
Trisomy 21 ◽  
Myeloid Leukemia ◽  
Clinical Findings ◽  
Myeloproliferative Disorder ◽  
Spontaneous Resolution ◽  
Transient Myeloproliferative Disorder ◽  
Life Threatening ◽  
History Of

Abstract Transient myeloproliferative disorder (TMD), restricted to newborns with trisomy 21, is a megakaryocytic leukemia that although lethal in some is distinguished by its spontaneous resolution. Later development of acute myeloid leukemia (AML) occurs in some. Prospective enrollment (n = 135) elucidated the natural history in Down syndrome (DS) patients diagnosed with TMD via the use of uniform monitoring and intervention guidelines. Prevalent at diagnosis were leukocytosis, peripheral blast exceeding marrow blast percentage, and hepatomegaly. Among those with life-threatening symptoms, most (n = 29/38; 76%) received intervention therapy until symptoms abated and then were monitored similarly. Organomegaly with cardiopulmonary compromise most frequently led to intervention (43%). Death occurred in 21% but only 10% were attributable to TMD (intervention vs observation patients: 13/14 vs 1/15 because of TMD). Among those solely observed, peripheral blasts and all other TMD symptoms cleared at a median of 36 and 49 days from diagnosis, respectively. On the basis of the diagnostic clinical findings of hepatomegaly with or without life-threatening symptoms, 3 groups were identified with differing survival: low risk with neither finding (38%), intermediate risk with hepatomegaly alone (40%), and high risk with both (21%; overall survival: 92% ± 8%, 77% ± 12%, and 51% ± 19%, respectively; P ≤ .001). Among all, AML subsequently occurred in 16% at a median of 441 days (range, 118-1085 days). The trial is registered at http://www.clinicaltrials.gov as NCT00003593.

scholarly journals Children’s Multisystem Inflammatory Syndrome, Associated With a New Coronavirus Infection (COVID-19): Relevant Information and Clinical Observation

2020 ◽  
Vol 17 (3) ◽  
pp. 219-229 ◽  
Author(s):  
Marina G. Kantemirova ◽  
Yulia Yu. Novikova ◽  
Dmitry Yu. Ovsyannikov ◽  
Seda Kh. Kurbanova ◽  
Anastasia A. Glazyrina ◽  
...  
Keyword(s):  
Information Search ◽  
Medical Records ◽  
Macrophage Activation ◽  
Clinical Observation ◽  
Relevant Information ◽  
Toxic Shock ◽  
Pubmed Database ◽  
Coronavirus Infection ◽  
Search For Information ◽  
Inflammatory Syndrome

Background. New coronaviral infection (COVID-19) in most cases has less severe course in children than in adults. However, there were reports from the number of European countries and from United States (from March 2020) about children with new disease with signs of Kawasaki disease (KD) and toxic shock syndrome (TSS). So it has received one of the names children’s multisystem inflammatory syndrome (CMIS) associated with COVID-19. The aim of the study is to summarize up-to-date information about this disease.Methods. Information search in PubMed database, CDC (USA) and WHO websites, Search for information in PubMed database, on CDC (USA) and WHO websites, analysis of the medical records of observed patient with CMIS.Results. Clinical and laboratoryinstrumental manifestation and outcomes of CMIS in 120 children from Italy, France, Switzerland, England, USA with similar signs were analyzed. Proposed international diagnostic criteria of the disease in comparison with other phenotypically similar diseases (KD, shock syndrome at KD, TSS of Staphylococcal and Streptococcal etiology, macrophage activation syndrome), clinical observation of patient, algorithm of evaluation and management of patients with CMIS are presented.

COVID-19 CHALLENGE, IN WHICH A THREE-YEAR-OLD GIRL WON

2021 ◽  
Vol 74 (10) ◽  
pp. 2530-2534
Author(s):  
Halyna O. Lytvyn ◽  
Mariia V. Stasiv ◽  
Volodymyr R. Mishchuk ◽  
Iryna Yu. Avramenko
Keyword(s):  
Clinical Laboratory ◽  
Successful Outcome ◽  
Toxic Shock ◽  
Ministry Of Health ◽  
Virus Rna ◽  
Life Saving ◽  
Life Threatening ◽  
Coronavirus Infection ◽  
Inflammatory Syndrome ◽  
Ventilation Of The Lungs

Since March 11, coronavirus infection has become an intercontinental problem – a pandemic has developed.Ukraine (until December 2019) ranks 17th in the world in the number of Covid-19 cases. Although according to statistics, the children are the least vulnerable group for coronavirus infection, unfortunately, severe and serious complications such as pneumonia, Kawasaki disease and Kawasaki-like syndrome, Multisystem inflammatory syndrome in children, toxic shock syndrome, myocarditis occur in children, too. As of the end of November, according to the Ministry of Health in Ukraine, 732,625 cases of coronavirus were laboratory- confirmed, including 13,720 children. According to the Lviv Regional Laboratory Center of the Ministry of Health, in the Lviv region since the beginning of the Covid-19 pandemic, among 46078 of all infected were about 5-6% of children. To analyze clinical, laboratory features of severe coronavirus infection complicated by bilateral pneumonia with acute respiratory distress syndrome (ARDS) in a three-year-old girl who was on V-V ECMO for one week and mechanical ventilation of the lungs for 28 days. The diagnosis was confirmed by detection of SARS-CoV-2 virus RNA by PCR, X-ray and ultrasound examination of the lungs. The disease had a dramatic course but a successful outcome. Life-threatening conditions associated with COVID-19 in children are much less common than in adult patients. However, in some cases, when critical hypoxemia is not eliminated by traditional methods of respiratory support, ECMO can become a life-saving technology and with its timely usage in pediatric patients.

scholarly journals Challenges of Pediatric Multisystem Inflammatory Syndrome Associated with Covid-19 - A Series of Clinical Cases

2020 ◽  
Vol 1 (4) ◽  
pp. 01-03
Author(s):  
Ninel Revenco
Keyword(s):  
Macrophage Activation ◽  
Clinical Presentation ◽  
Signs And Symptoms ◽  
Clinical Aspects ◽  
Toxic Shock ◽  
Epidemiological Evidence ◽  
Organ Systems ◽  
The Republic ◽  
Inflammatory Syndrome ◽  
Inflammation Parameters

Background According to the first SARS-CoV-2 pandemic data, signs and symptoms were less frequently reported among pediatric patients versus adults. Later in April, was described as the multisystem inflammatory syndrome in children (MIS-C) associated with COVID -19. The clinical presentation of MIS-C includes fever, simultaneous involvement of two or more organ systems, altered inflammation parameters and laboratory or epidemiological evidence of SARS-CoV-2 infection. MIS-C features some similar clinical aspects with Kawasaki disease, toxic shock syndrome, and secondary hemophagocytic lymph histiocytosis syndrome / macrophage activation syndrome. This review describes the clinical features of 7 cases of MIS-C treated in the Republic of Moldova.

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