Zainab A Almoosa, Heba H Al Ameer, Sajjad M AlKadhem, Fadi Busaleh, Fatimah A AlMuhanna, Osama Kattih
Fortunately, coronavirus disease 2019 (COVID-19) infection in pediatric populations exhibits a mild course of disease. However, a small number have recently been identified who develop a significant systemic inflammatory response, a new disease entity called multisystem inflammatory syndrome in children (MIS-C), especially after the peak of the wave in Al-Ahsa, Saudi Arabia, in early June to mid-July. In MIS-C children usually present a few days to a few weeks after recovery from COVID-19 with high grade fever, GI symptoms, Kawasaki-like picture or even toxic shock-like syndrome...
October 20, 2020: Curēus
Elena Galli, Francesca Cipriani, Giampaolo Ricci, Nunzia Maiello
BACKGROUND: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, causing COVID-19, is rapidly spread across the world, by posing novel challenges for all physicians. Cutaneous manifestations of COVID-19 may be present in 20% of patients, but they are still now poorly characterized. METHODS: We search literature to describe all the various cutaneous manifestation observed during COVID-19 pandemic. RESULTS: Different cutaneous clinical patterns were described, showing a wide polymorphism...
November 2020: Pediatric Allergy and Immunology
Francesco La Torre, Lucia Leonardi, Giuliana Giardino, Stefano Volpi, Silvia Federici, Annarosa Soresina, Caterina Cancrini, Vassilios Lougaris, Riccardo Castagnoli, Stefania Corrente, Fabio Cardinale
COVID-19 is a complex new viral disease, in which a strict balance between anti-viral immune response and the ensuing organ inflammation has a critical role in determining the clinical course. In adults, compelling evidence exists indicating that an uncontrolled inflammatory response ("cytokine storm") is pivotal in determining disease progression and mortality. Children may rarely present with severe disease. Modulating factors related to the host's genetic factors, age-related susceptibility, and the capability to mount appropriate immune responses might play a role in control virus load at an early stage and regulating the inflammatory reaction...
November 2020: Pediatric Allergy and Immunology
Guillermo Kohn-Loncarica, Ana Fustiñana, Franco Díaz-Rubio, Juan C Jaramillo-Bustamante, Sebastián González-Dambrauskas, Pablo Vásquez-Hoyos, Jaime Fernández-Sarmiento, Gustavo González, Alejandro Mansur, Javier Ponce, Roberto Jabornisky
Multisystem inflammatory syndrome temporally related to COVID-19 in children and adolescents is a clinical presentation of SARS-CoV-2 infection. It shares some features with Kawasaki disease, toxic shock, sepsis, macrophage activation syndrome, and myocarditis. Few publications have addressed its initial management, which is similar to that proposed for septic shock. This review analyzes such approach based on the characteristics typical of multisystem inflammatory syndrome related to COVID-19 in accordance with the paradigm of an "institutional practice guideline" and suggests therapeutic approach strategies, including early detection, stabilization, referral, specific treatment, and process analysis...
December 2020: Archivos Argentinos de Pediatría
Muserref Kasap Cuceoglu, Seza Ozen
Vasculitides are defined according to the vessel size involved, and they tend to affect certain organ systems. Pulmonary involvement is rare in the common childhood vasculitides, such as Kawasaki disease, IgA vasculitis (Henoch Schonlein purpura). On the other hand, lung involvement is common in a rare pediatric vasculitis, granulomatosis with polyangiitis (GPA) (Wegener granulomatosis), where respiratory system findings are common. A criterion in the Ankara 2008 classification criteria for GPA is the presence of nodules, cavities, or fixed infiltrates...
February 2021: Pediatric Clinics of North America
L Charles Bailey, Hanieh Razzaghi, Evanette K Burrows, H Timothy Bunnell, Peter E F Camacho, Dimitri A Christakis, Daniel Eckrich, Melody Kitzmiller, Simon M Lin, Brianna C Magnusen, Jason Newland, Nathan M Pajor, Daksha Ranade, Suchitra Rao, Olamiji Sofela, Janet Zahner, Cortney Bruno, Christopher B Forrest
Importance: There is limited information on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing and infection among pediatric patients across the United States. Objective: To describe testing for SARS-CoV-2 and the epidemiology of infected patients. Design, Setting, and Participants: A retrospective cohort study was conducted using electronic health record data from 135 794 patients younger than 25 years who were tested for SARS-CoV-2 from January 1 through September 8, 2020...
November 23, 2020: JAMA Pediatrics
Daniel R Mazori, Kristina M Derrick, Urvi Kapoor, Minoti Haribhai, Ramon E Gist, Sharon A Glick
Multisystem inflammatory syndrome in children (MIS-C) is a syndrome associated with coronavirus disease 2019. Various phenotypes of MIS-C have been described including Kawasaki disease (KD). Although perineal desquamation is a known early sign of KD, to our knowledge, this rash has not yet been described in the KD phenotype of MIS-C. In this article, we report two patients in whom perineal desquamation was an early clue for the KD phenotype of MIS-C.
November 22, 2020: Pediatric Dermatology
Jayakanthan Kabeerdoss, Rakesh Kumar Pilania, Reena Karkhele, T Sathish Kumar, Debashish Danda, Surjit Singh
Multisystem inflammatory syndrome (MIS-C) is a pediatric hyperinflammation disorder caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). It has now been reported from several countries the world over. Some of the clinical manifestations of MIS-C mimic Kawasaki disease (KD) shock syndrome. MIS-C develops 4-6 weeks following SARS-CoV-2 infection, and is presumably initiated by adaptive immune response. Though it has multisystem involvement, it is the cardiovascular manifestations that are most prominent...
November 21, 2020: Rheumatology International
MacKenzie W Burger, Marcus A Moore, John M Wilburn
INTRODUCTION: Coronavirus disease 2019 (COVID-19) rarely manifests with severe complications in pediatric patients. An association between COVID-19 and a Kawasaki-like inflammatory syndrome has recently presented in pediatric patients. CASE REPORT: We report a unique case of multisystem inflammatory syndrome in children presenting with characteristic findings in a child who later developed cardiogenic shock requiring venoarterial extracorporeal membrane oxygenation...
November 2020: Clinical Practice and Cases in Emergency Medicine
Noor Ul Falah, Shahnawaz Hashmi, Zahoor Ahmed, Ali Jaan, Ali Akhtar, Farhan Khalid, Umar Farooque, Muhammad Tayyab Shera, Sundas Ali, Ayesha Javed
Children with coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), usually present with symptoms of mild upper respiratory tract infection without developing any significant complications. However, this observation has been rendered incautious by hundreds of clinical cases from around the world that have depicted a less benign multisystem inflammatory illness mimicking Kawasaki disease in COVID-positive pediatric patients. Our study aimed at retrospectively reviewing the different features of Kawasaki disease-like illness in children suffering from COVID-19, including the complications, laboratory investigations, treatment strategies used during their hospital stay, and outcomes...
October 19, 2020: Curēus
Akinori Sekioka, Koji Fukumoto, Tatsuya Kawasaki, Masashi Koyama, Yoh Fujimoto, Hiromu Miyake, Akiyoshi Nomura, Susumu Yamada, Risa Kanai, Akihiro Makino, Naoto Urushihara
Constant neck flexion has been considered crucial to reducing anastomotic tension after tracheal resection. However, in rare cases, anteflexion can cause cervical cord damage, leading to acute neurological disorders such as tetraplegia. Here, we report a case of 5-year-old boy presenting with acute neurological disorder triggered by a chin-to-chest position over 4 days of deep sedation after cricotracheal resection. The radiological findings would suggest a mechanism similar to Hirayama disease, in which a shift of the dura leads to chronic muscular weakness and atrophy in young populations...
November 11, 2020: International Journal of Pediatric Otorhinolaryngology
Maryam Khalili, Behzad Iranmanesh, Saman Mohammadi, Mahin Aflatoonian
Prevalence of dermatologic manifestations of COVID-19 disease is estimated between 0.25 % and 3% in children and adolescents. In this review article, we decided to describe cutaneous and histopathological manifestations of COVID-19 infection in pediatrics. We searched published articles in PubMed database for key words of 'children" or "pediatric" and "cutaneous" or "dermatology "or "skin" and "COVID-19" or "SARS-CoV-2" or "Coronavirus disease 2019" in abstract or title from December of 2019 until September 2020...
November 18, 2020: Dermatologic Therapy
Marlos Melo Martins, Arnaldo Prata-Barbosa, Maria Clara de Magalhães-Barbosa, Antonio José Ledo Alves da Cunha
OBJECTIVE: To present the current evidence on clinical and laboratory characteristics of infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during childhood and adolescence. DATA SOURCE: This is a narrative review conducted in the databases: Medical Literature Analysis and Retrieval System Online (MEDLINE/PubMed), Latin American and Caribbean Health Sciences Literature in the Virtual Health Library (LILACS/VHL), Scopus, Web of Science, Cochrane Library, portal of the Coordination for the Improvement of Higher Education Personnel (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES), Scientific Electronic Library Online (SciELO), ScienceDirect, and Cumulative Index to Nursing and Allied Health Literature (CINAHL)...
2020: Revista Paulista de Pediatria: Orgão Oficial da Sociedade de Pediatria de São Paulo
Hua Zou, Juan Lu, Jingjing Liu, Josiah Hiu-Yuen Wong, Si Cheng, Qiuhong Li, Yan Shen, Chunli Li, Xiaojiong Jia
OBJECTIVES: There was an outbreak of pediatric multisystem inflammation syndrome (PMIS) was observed in multiple countries recently, and this syndrome was suspected to be associated with SARS-CoV-2 infection. At present, there is still no standardized diagnostic criteria and treatment regimen for PMIS, while the etiology and pathogenesis still remain unclear. METHODS: We performed a systematic review on PubMed and Embase from the time of inception to June 24th 2020 in order to find relevant cases...
November 14, 2020: International Journal of Infectious Diseases: IJID
Brenda Fortuna-Reyna, Emelia V Bainto, Rolando Ulloa-Gutierrez, Luis M Garrido-García, Dora Estripeaut, Olguita Del Águila, Virgen Gómez, Enrique Faugier-Fuentes, Greta Miño-León, Sandra Beltrán, Fernanda Cofré, Enrique Chacón-Cruz, Patricia Saltigeral-Simental, Lucila Martínez-Medina, Lourdes Dueñas, Kathia Luciani, Francisco J Rodríguez-Quiroz, German Camacho-Moreno, Tamara Viviani, Martha I Alvarez-Olmos, Heloisa Helena de Sousa Marques, Eduardo López-Medina, María C Pirez, Adriana H Tremoulet
Objective: To characterize the use of adjunctive therapy in Kawasaki disease (KD) in Latin America. Methods: The study included 1,418 patients from the Latin American KD Network (REKAMLATINA) treated for KD between January 1, 2009, and May 31, 2017. Results: Of these patients, 1,152 received only a single dose of IVIG, and 266 received additional treatment. Age at onset was similar in both groups (median 2 vs. 2.2 years, respectively). The majority of patients were male (58 vs. 63.9%) and were hospitalized with the first 10 days of fever (85...
2020: Frontiers in Pediatrics
Tsukasa Tanaka, Masaki Shimizu, Oshi Tokuda, Hiroko Yamamoto, Natsuki Matsunoshita, Kanae Takenaka, Keiichiro Kawasaki
Background: Kawasaki disease (KD) is typically characterized by fever, oral cavity erythematous changes, bilateral bulbar conjunctival injection, skin rash, erythema and edema of the hands and feet, and cervical lymphadenopathy. Some atypical patients with KD initially develop cervical and pharyngeal cellulitis; however, an initial presentation with inguinal cellulitis is extremely rare. In addition, to our knowledge, no report has documented the cytokine profile in a KD patient with cellulitis...
2020: Case Reports in Pediatrics
Ricardo Carbajal, Mathie Lorrot, Yael Levy, Emmanuel Grimprel, Thibault Lecarpentier, Sebastien Heritier, Judith Faivre, Aurélie Schnuriger, Pauline Parisot, Eléonore Blondiaux, Solene Loschi, Simon Rivière, Julia Guilbert, Anne-Sophie Romain, Pierre-Louis Leger, Romain Guedj
AIM: This study determined the influence of the COVID-19 pandemic on the occurrence of multisystem inflammatory syndrome in children (MIS-C) and compared the main characteristics of MIS-C and Kawasaki disease (KD). METHODS: We included patients aged up to 18 years of age who were diagnosed with MIS-C or KD in a paediatric university hospital in Paris from 1 January 2018 to 15 July 2020. Clinical, laboratory and imaging characteristics were compared and new French COVID-19 cases were correlated with MIS-C cases in our hospital...
November 15, 2020: Acta Paediatrica
Fernanda Lima-Setta, Maria Clara de Magalhães-Barbosa, Gustavo Rodrigues-Santos, Elaine Augusta das Neves Figueiredo, Melissa de Lorena Jacques, Raquel de Seixas Zeitel, Roberto Sapolnik, Cibelle Teixeira da Siva Borges, Vanessa Soares Lanziotti, Roberta Esteves Vieira de Castro, Ana Paula Novaes Bellinat, Thiago Peres da Silva, Felipe Rezende Caino de Oliveira, Bárbara Carvalho Santos Dos Reis, Natália Almeida de Arnaldo Silva Rodriguez Castro, João Henrique Garcia Cobas Macedo, Ana Carolina Cabral Pinheiro Scarlato, Paula Marins Riveiro, Isabele Coelho Fonseca da Mota, Vivian Botelho Lorenzo, Natalia Martins Lima de Lucena, Zina Maria Almeida de Azevedo, Antonio José L A Cunha, Arnaldo Prata-Barbosa
OBJECTIVE: To describe the clinical, laboratory, and radiological characteristics, as well as the outcomes of children with MIS-C. METHOD: Multicenter, prospective cohort study, conducted in 17 pediatric intensive care units in five states in Brazil, from March to July 2020. Patients from 1 month to 19 years who met the MIS-C diagnostic criteria were included consecutively. RESULTS: Fifty-six patients were included, with the following conditions: Kawasaki-like disease (n = 26), incomplete Kawasaki disease (n = 16), acute cardiac dysfunction (n = 10), toxic shock syndrome (n = 3), and macrophage activation syndrome (n = 1)...
November 9, 2020: Jornal de Pediatria
Zerrin Orbak, Fuat Laloglu, Hulya Akat
The large outbreak of coronavirus disease 2019 (COVID-19) is spreading all over the world rapidly. There have recently been publications in the literature regarding the relationship between COVID 19 and Kawasaki disease but there is no sufficient knowledge about treatment and follow-up.Here, a pediatric case with Kawasaki disease associated with 2019-nCoV infection and successful treatment of covid-19 related pneumonia with lopinavir/ritonavir is reported.
November 13, 2020: Cardiology in the Young
Raúl Bustos B, Juan Camilo Jaramillo-Bustamante, Pablo Vasquez-Hoyos, Pablo Cruces, Franco Díaz
Pediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus 2 (PIMS-TS) is infrequent, but children might present as a life-threatening disease. In a systematic quantitative review, we analyzed 11 studies of PIMS-TS, including 468 children reported before July 1, 2020. We found a myriad of clinical features, but we were able to describe common characteristics: previously healthy school-aged children, persistent fever and gastrointestinal symptoms, lymphopenia, and high inflammatory markers...
November 10, 2020: Pediatric Emergency Care
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