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An unusual presentation of Covid-19 in a patient with acute abdomen. HUMAN PATHOLOGY REPORTS 2022. [PMCID: PMC8977482 DOI: 10.1016/j.hpr.2022.300631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Azılı MN, Güney D, Oztorun CI, Ertürk A, Erten EE, Demir S, Ertoy A, Emeksiz S, Parlakay AO, Celikel BA, Senel E. Determination of Factors to Distinguish MIS-C from Acute Appendicitis in Children with Acute Abdominal Pain. Eur J Pediatr Surg 2022; 32:240-250. [PMID: 34298578 DOI: 10.1055/s-0041-1732320] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
INTRODUCTION The aim of this study was to make the differential diagnosis between acute appendicitis and multisystem inflammatory syndrome in children (MIS-C) for patients presenting with the complaint of acute abdominal pain (AAP) and to identify the determining factors for the diagnosis of MIS-C. MATERIALS AND METHODS Eighty-one children presenting with AAP/suspected AAP were evaluated. Of these, 24 (29.6%) were included in the MIS-C group (MIS-C/g) and 57 were included in the suspected appendicitis group (S-A/g), which consisted of two subgroups: appendicitis group (A/g) and control observation group (CO/g). RESULTS Comparing MIS-C/g, A/g, and CO/g, duration of abdominal pain (2.4, 1.5, 1.8 days), high-grade fever (38.8, 36.7, 37°C), severe vomiting, and severe diarrhea were higher in MIS-C/g. Lymphocytes count (LC) was lower, while values of C-reactive protein (CRP), ferritin, and coagulopathy were higher in MIS-C/g (p < 0.05). The optimal cutoffs for the duration of abdominal pain was 2.5 days; the duration of fever, 1.5 days; peak value of fever, 39°C; neutrophil count, 13,225 × 1,000 cell/µMoL; LC, 600 × 1,000 cell/µMoL; ferritin, 233 µg/L; and D-dimer, 16.4 mg/L (p < 0.05). The optimal cutoff for CRP was 130 mg/L (sensitivity 88.9, specificity 100%, positive predictive value 100%, NPV, negative predictive value 92.5%, p < 0.001). All patients in MIS-C/g tested positive by serology by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). CONCLUSION The duration of abdominal pain, presence of high-grade and prolonged fever, and evaluation of hemogram in terms of high neutrophil count and low LC exhibit high sensitivity and negative predictive value for MIS-C presenting with AAP. In case of doubt, inflammatory markers such as CRP, ferritin, D-dimer, and serology for SARS-CoV-2 should be studied to confirm the diagnosis.
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Affiliation(s)
- Müjdem Nur Azılı
- Department of Pediatric Surgery, Ankara City Children's Hospital, Ankara Yildirim Beyazit University, Ankara, Turkey.,Department of Pediatric Surgery, Ankara City Hospital, Cankaya, Ankara, Turkey
| | - Doğuş Güney
- Department of Pediatric Surgery, Ankara City Children's Hospital, Ankara Yildirim Beyazit University, Ankara, Turkey.,Department of Pediatric Surgery, Ankara City Hospital, Cankaya, Ankara, Turkey
| | - Can Ihsan Oztorun
- Department of Pediatric Surgery, Ankara City Children's Hospital, Ankara Yildirim Beyazit University, Ankara, Turkey.,Department of Pediatric Surgery, Ankara City Hospital, Cankaya, Ankara, Turkey
| | - Ahmet Ertürk
- Department of Pediatric Surgery, Ankara City Hospital, Cankaya, Ankara, Turkey
| | - Elif Emel Erten
- Department of Pediatric Surgery, Ankara City Hospital, Cankaya, Ankara, Turkey
| | - Sabri Demir
- Department of Pediatric Surgery, Ankara City Hospital, Cankaya, Ankara, Turkey
| | - Ayşe Ertoy
- Department of Pediatric Surgery, Ankara City Hospital, Cankaya, Ankara, Turkey
| | - Serhat Emeksiz
- Department of Pediatric Intensive Care, Ankara Yildirim Beyazit University, Ankara, Turkey.,Department of Pediatric Intensive Care, Ankara City Hospital, Cankaya, Ankara, Turkey
| | - Aslınur Ozkaya Parlakay
- Department of Pediatric Infection, Ankara Yildirim Beyazit University, Ankara, Turkey.,Department of Pediatric Infection, Ankara City Hospital, Cankaya, Ankara, Turkey
| | - Banu Acar Celikel
- Department of Pediatric Rheumatology, Ankara City Hospital, Cankaya, Ankara, Turkey
| | - Emrah Senel
- Department of Pediatric Surgery, Ankara City Children's Hospital, Ankara Yildirim Beyazit University, Ankara, Turkey.,Department of Pediatric Surgery, Ankara City Hospital, Cankaya, Ankara, Turkey
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Motazedian G, Aryanpoor P, Rahmanian E, Abiri S, Kalani N, Hatami N, Bagherian F, Etezadpour M, Farzaneh R, Maleki F, Foroughian M, Ghaedi M. Incidence of Pediatric Perforated Appendicitis during the COVID-19 Pandemic; a Systematic Review and Meta-Analysis. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE 2022; 10:e3. [PMID: 35072092 PMCID: PMC8771157 DOI: 10.22037/aaem.v10i1.1421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION COVID-19 has affected the pattern of referral to medical centers and quarantine against COVID-19 might delay referral and management of surgical emergencies. This study aimed to compare the pooled event rate of pediatric perforated appendicitis before and during the COVID-19 pandemic. METHODS This was a systematic review and meta-analysis study based on the PRISMA guidelines. Scopus, Web of Sciences, and PubMed databases were searched for studies reporting the rate of perforated appendicitis based on the post-appendectomy observations or imaging methods. The Egger bias test and funnel plot were used to detect and depict publication bias. Statistical analysis was performed in Comprehensive Meta-analysis package version 3. RESULTS Twelve studies were eligible for inclusion in our study. The pooled prevalence of pediatric perforated appendicitis in the pre-COVID era was 28.5% (CI95%: 28.3 to 28.7%) with a heterogeneity of 99%. In the COVID era, the event rate proportion was 39.4% (CI95%: 36.6 to 42.3%) with a heterogeneity of 99%. There was a significant difference in the subgroup analysis within the pre-COVID and COVID era (P<0.001), showing a higher perforation rate in the COVID era. CONCLUSION Our study showed that during the COVID-19 pandemic, the rate of perforated appendicitis has significantly increased in comparison to before the COVID-19 pandemic.
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Affiliation(s)
- Gholamreza Motazedian
- Plastic & Reconstructive Surgery Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Poorya Aryanpoor
- Student Research Committee, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Ehsan Rahmanian
- Research center for social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Samaneh Abiri
- Research center for social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Navid Kalani
- Research center for social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Naser Hatami
- Student Research Committee, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Farhad Bagherian
- Department of Emergency Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Mohammad Etezadpour
- Surgery department, Faculty of Medicine, Mashhad University of Medical sciences, Mashhad, Iran
| | - Roohie Farzaneh
- Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Maleki
- Department of Emergency Medicine, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Mahdi Foroughian
- Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mojtaba Ghaedi
- Plastic Surgery department, Jahrom University of Medical Sciences, Jahrom, Iran
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"Inflammatory peritonitis in a child with COVID-19″. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2021; 75:102077. [PMID: 34660197 PMCID: PMC8511549 DOI: 10.1016/j.epsc.2021.102077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/06/2021] [Accepted: 10/12/2021] [Indexed: 01/08/2023] Open
Abstract
COVID-19 is the disease caused by SARS-COV-2 coronavirus infection (Severe acute respiratory syndrome coronavirus 2). Although its most prevalent symptoms are respiratory, there are descriptions of gastrointestinal manifestations in children, but the presentation as an acute abdomen is rare. We report the case of a 6-month-old infant who was admitted with a diagnosis of intestinal obstruction and generalized peritonitis with no apparent cause, in whom a SARS-CoV-2 rt-PCR search was positive. We have not found descriptions of similar cases in the literature so far.
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Salman H, Aslan N, Akçam M, Arslan M, Akkuzu E, Yılmaz Keskin E, Açarı C, Keskin M, Atar M, Köşker M, Sinanoğlu S, Çetin H, Akçam FZ. COVID-19-associated multisystem inflammatory syndrome in children: Experiences of three centres in Turkey. Mod Rheumatol 2021; 32:460-466. [PMID: 34910197 PMCID: PMC8499971 DOI: 10.1093/mr/roab042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/31/2021] [Accepted: 07/14/2021] [Indexed: 11/13/2022]
Abstract
BACKGROUND The pathogenesis and clinical manifestations of the multisystem inflammatory syndrome in children (MIS-C) has not yet been fully elucidated and there is no clear consensus on its treatment yet. OBJECTIVES To evaluate our patients diagnosed with MIS-C and present them to the literature in order to contribute to the better understanding of this new disease, which entered paediatric practice with the SARS-CoV-2 peak. METHODS In this study, 17 MIS-C cases diagnosed according to the Centers for Disease Control and Prevention criteria were included. RESULTS Of the patients, 7 (41.2%) had a comorbidity. Gastrointestinal system involvement was the most prominent in the patients (70.6%). Laparotomy was performed in 3 patients due to acute abdomen. Two patients had neurological involvement. Of the patients, 15 (88.2%) received intravenous immunoglobulin and 13 (76.5%) received both intravenous immunoglobulin and methylprednisolone. Two patients received invasive mechanical ventilation and 4 patients received high flow rate nasal cannula oxygen therapy. One of our patients who needed invasive mechanical ventilation and high vasoactive-inotrope support died despite all supportive treatments including plasmapheresis and extracorporeal membrane oxygenation. CONCLUSIONS MIS-C picture can have a fatal course and may present with severe gastrointestinal and neurological signs. Unnecessary laparotomy should be avoided.
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Affiliation(s)
- Hakan Salman
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Medical School, Suleyman Demirel University, Isparta, Turkey
| | - Nagehan Aslan
- Division of Pediatric Intensive Care Unit, Department of Pediatrics, Malatya Training and Research Hospital, Malatya, Turkey
| | - Mustafa Akçam
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Medical School, Suleyman Demirel University, Isparta, Turkey
| | - Müjgan Arslan
- Division of Pediatric Neurology, Medical School, Department of Pediatrics, Suleyman Demirel University, Isparta, Turkey
| | - Emine Akkuzu
- Division of Pediatric Intensive Care Unit, Department of Pediatrics, Isparta State Hospital, Isparta, Turkey
| | - Ebru Yılmaz Keskin
- Division of Pediatric Hematology, Medical School, Department of Pediatrics, Suleyman Demirel University, Isparta, Turkey
| | - Ceyhun Açarı
- Division of Pediatric Rheumatology, Department of Pediatrics, Malatya Training and Research Hospital, Malatya, Turkey
| | - Mahmut Keskin
- Division of Pediatric Cardiology, Medical School, Department of Pediatrics, Suleyman Demirel University, Isparta, Turkey
| | - Müge Atar
- Division of Pediatric Endocrinology, Medical School, Department of Pediatrics, Suleyman Demirel University, Isparta, Turkey
| | - Muhammet Köşker
- Division of Pediatric Infectious Disease, Department of Pediatrics, Antalya Training and Research Hospital, Antalya, Turkey
| | - Selçuk Sinanoğlu
- Department of Pediatrics, Malatya Training and Research Hospital, Malatya, Turkey
| | - Hasan Çetin
- Division of Neonatology, Department of Pediatrics, Medical School, Suleyman Demirel University, Isparta, Turkey
| | - Füsun Zeynep Akçam
- Medical School, Department of Infectious Diseases and Clinical Microbiology, Suleyman Demirel University, Isparta, Turkey
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Malbul K, Katwal S, Maharjan S, Shrestha S, Dhital R, Rajbhandari AP. Appendicitis as a presentation of COVID-19: A case report. Ann Med Surg (Lond) 2021; 69:102719. [PMID: 34422263 PMCID: PMC8372448 DOI: 10.1016/j.amsu.2021.102719] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/11/2021] [Accepted: 08/13/2021] [Indexed: 01/06/2023] Open
Abstract
Background Coronavirus disease-19 (COVID-19) is an infectious respiratory disease caused by Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2). Respiratory symptoms and flu-like presentation are the most defined clinical manifestations. However, gastrointestinal symptoms with acute abdomen have been reported in a small percentage, occasionally mimicking acute appendicitis. Hence, the diagnosis of COVID-19 should be suspected and investigated in every case of acute abdomen in the present situation. Case presentation We report a case of a 25-year-old male who presented with features of acute appendicitis. Despite the equivocal ultrasound results, he was scheduled for an emergency appendectomy for Alvarado's score 7 out of 10, who underwent a successful appendectomy. The patient had initially tested negative on an upper respiratory COVID-19 reverse transcription-polymerase chain reaction (RT-PCR) with normal chest X-ray but few hours after the surgery patient developed a high-grade fever. An RT-PCR for COVID-19 was resent following a suspicion that came out to be positive. Clinical discussion Several case reports have suggested a probable association between COVID-19 and appendicitis. This case shows the limited effectiveness of clinical diagnosis for the surgical abdomen in COVID-19 patients as these two conditions share similar symptoms often needing a clinical vigilance. Conclusion This case reports acute appendicitis in a patient who tested positive for SARS-CoV-2 subsequently following emergency appendectomy highlighting the acute gastrointestinal presentation of COVID-19. This case exemplifies the necessity to be familiar with the gastrointestinal symptoms of COVID-19 and maintain a high level of suspicion for COVID-19 infection in cases of abdominal pain. Acute appendicitis can be one of the presentation of COVID-19. Clinicians need to be familiar with the gastrointestinal symptoms of COVID-19. Rapid diagnosis of COVID-19 in patients with acute abdominal pain should be done to prevent the virus from spreading. A negative RT-PCR for COVID-19 can't totally exclude COVID-19.
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Affiliation(s)
- Kiran Malbul
- Nepalese Army Institute of Health Sciences College of Medicine, Sanobharyang, Kathmandu, Nepal
| | - Srijana Katwal
- Nepalese Army Institute of Health Sciences College of Medicine, Sanobharyang, Kathmandu, Nepal
| | - Swojay Maharjan
- Nepalese Army Institute of Health Sciences College of Medicine, Sanobharyang, Kathmandu, Nepal
| | - Suraj Shrestha
- Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal
| | - Roman Dhital
- Nepal National Hospital, Kalanki, Kathmandu, Nepal
| | - Ashish Prasad Rajbhandari
- Department of GI and General Surgery, Nepal Medical College Teaching Hospital, Jorpati, Kathmandu, Nepal
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Pirola L, Palermo A, Mulinacci G, Ratti L, Fichera M, Invernizzi P, Viganò C, Massironi S. Acute mesenteric ischemia and small bowel imaging findings in COVID-19: A comprehensive review of the literature. World J Gastrointest Surg 2021; 13:702-716. [PMID: 34354803 PMCID: PMC8316849 DOI: 10.4240/wjgs.v13.i7.702] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/12/2021] [Accepted: 07/02/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19), an infectious condition caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly spread worldwide since its first description in Wuhan in December 2019. Even though respiratory manifestations are the most prevalent and responsible for disease morbidity and mortality, extrapulmonary involvement has progressively gained relevance. In particular, gastrointestinal (GI) signs and symptoms, reported in up to two-thirds of patients with COVID-19, might represent the first and, in some cases, the only disease presentation. Their presence has been associated in some studies with an increased risk of a severe disease course. Proposed pathogenic mechanisms explaining GI tract involvement are either direct viral access to intestinal cells via angiotensin-converting enzyme 2 or indirect damage of the intestinal wall through mesenteric ischemia induced by the hypercoagulable state associated with COVID-19 infection. Although not typical of SARS-CoV-2 infection, several small bowel manifestations have been described in infected patients who underwent any form of abdominal imaging. The radiological findings were mainly reported in patients with abdominal symptoms, among which abdominal pain was the most common.
AIM To discuss small bowel radiological manifestations of SARS-CoV-2 infection in abdominal imaging studies.
METHODS Bibliographical searches were performed in PubMed, using the following keywords: “COVID-19” AND “imaging” AND “gastrointestinal” OR “abdominal” OR “small bowel”.
RESULTS Of 62 patients with described radiologic small bowel alterations, mesenteric ischemia was diagnosed in 31 cases (50%), small bowel wall thickening in 10 cases (16%), pneumatosis in nine cases (15%), intussusception in eight cases (13%), pneumoperitoneum in two cases (3%) and paralytic ileus in two cases (3%). We also reported mesenteric adipose tissue hypertrophy and lymph nodes enlargement in a young woman.
CONCLUSION So far it is difficult to establish whether these manifestations are the direct consequence of SARS-CoV-2 infection or collateral findings in infected patients, but their recognition would be pivotal to set a closer follow-up and to reduce missed diagnoses.
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Affiliation(s)
- Lorena Pirola
- Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca, Monza 20900, Italy
- European Reference Network on Hepatological Diseases, San Gerardo Hospital, Monza 20900, Italy
| | - Andrea Palermo
- Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca, Monza 20900, Italy
- European Reference Network on Hepatological Diseases, San Gerardo Hospital, Monza 20900, Italy
| | - Giacomo Mulinacci
- Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca, Monza 20900, Italy
- European Reference Network on Hepatological Diseases, San Gerardo Hospital, Monza 20900, Italy
| | - Laura Ratti
- Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca, Monza 20900, Italy
- European Reference Network on Hepatological Diseases, San Gerardo Hospital, Monza 20900, Italy
| | - Maria Fichera
- Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca, Monza 20900, Italy
- European Reference Network on Hepatological Diseases, San Gerardo Hospital, Monza 20900, Italy
| | - Pietro Invernizzi
- Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca, Monza 20900, Italy
- European Reference Network on Hepatological Diseases, San Gerardo Hospital, Monza 20900, Italy
| | - Chiara Viganò
- Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca, Monza 20900, Italy
- European Reference Network on Hepatological Diseases, San Gerardo Hospital, Monza 20900, Italy
| | - Sara Massironi
- Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca, Monza 20900, Italy
- European Reference Network on Hepatological Diseases, San Gerardo Hospital, Monza 20900, Italy
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Jurkiewicz B, Szymanek-Szwed M, Hartmann P, Samotyjek J, Brędowska E, Kaczorowska J, Wajszczuk E, Twardowska-Merecka M, Cybulska J. Pediatric Multisystem Inflammatory Syndrome in Children as a Challenging Problem for Pediatric Surgeons in the COVID 19 Pandemic-A Case Report. Front Pediatr 2021; 9:677822. [PMID: 34178893 PMCID: PMC8225948 DOI: 10.3389/fped.2021.677822] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 05/17/2021] [Indexed: 01/29/2023] Open
Abstract
The first cases of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection were identified at the end of 2019 and, in the next few months, coronavirus disease (COVID-19) spread throughout the world. Initially, it was believed that this disease mainly affected elderly individuals with comorbidities, in whom respiratory failure often occurs. It was believed that children fell ill from the infection more often, although the course of infection in the vast majority of pediatric cases has been asymptomatic or mildly symptomatic. In April and May 2020, the first report of a rapidly progressing disease, similar to Kawasaki syndrome, was found in children who had been infected with SARS-CoV-2. Shortly thereafter, children with symptoms of pediatric inflammatory multisystem syndrome (PIMS-ST [temporally associated with SARS-CoV-2 infection]) began presenting to pediatric hospitals around the world. The syndrome has a mortality rate of up to 2%. Symptoms of PIMS-TS include those that may suggest the need for surgical treatment (severe abdominal pain with the presence of peritoneal symptoms, ascites, high levels of inflammatory markers, intestinal inflammation, and appendages revealed on ultrasound examination). However, there are few reports addressing surgical cases associated with this condition. The authors present a case involving an 11-year-old boy who was admitted to hospital with severe abdominal pain and underwent surgery for symptoms of peritonitis and was diagnosed with PIMS in the post-operative period. Due to the large number of illnesses caused by SARS-CoV-2 infection in recent months, the diagnosis of PIMS-TS/MISC should be considered in the differential diagnosis of acute abdominal symptoms, especially in atypical courses and interviews indicating exposure to SARS-CoV-2.
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Affiliation(s)
- Beata Jurkiewicz
- Department of Pediatric Surgery and Pediatric Urology, Medical Center of Postgraduate Education, Dziekanów Leśny, Poland
| | - Magdalena Szymanek-Szwed
- Department of Pediatric Surgery and Pediatric Urology, Medical Center of Postgraduate Education, Dziekanów Leśny, Poland
| | - Piotr Hartmann
- Department of Pediatrics, Children's Hospital, Dziekanów Leśny, Poland
| | - Joanna Samotyjek
- Department of Pediatric Surgery and Pediatric Urology, Medical Center of Postgraduate Education, Dziekanów Leśny, Poland
| | - Eliza Brędowska
- Department of Pediatrics, Children's Hospital, Dziekanów Leśny, Poland
| | | | - Ewa Wajszczuk
- Department of Pediatric Surgery and Pediatric Urology, Medical Center of Postgraduate Education, Dziekanów Leśny, Poland
| | - Martyna Twardowska-Merecka
- Department of Pediatric Surgery and Pediatric Urology, Medical Center of Postgraduate Education, Dziekanów Leśny, Poland
| | - Joanna Cybulska
- Department of Pediatric Surgery and Pediatric Urology, Medical Center of Postgraduate Education, Dziekanów Leśny, Poland
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Soto JA, Méndez MI, Berman JD. Case Report: COVID-19 Misdiagnosed as a Drug Reaction to Miltefosine. Am J Trop Med Hyg 2021; 104:1659-1660. [PMID: 33705346 PMCID: PMC8103461 DOI: 10.4269/ajtmh.20-1510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 02/26/2021] [Indexed: 01/07/2023] Open
Abstract
We present case reports of two patients treated with miltefosine for mucocutaneous leishmaniasis whose gastrointestinal symptoms were initially diagnosed as a drug reaction and only later recognized as due to COVID-19. Gastrointestinal symptoms of COVID-19 are unusual, whereas gastrointestinal adverse drug reactions are very common. These reports exemplify that this infrequent presentation of COVID-19 is likely to be ascribed to a more common etiology such as a gastrointestinal drug reaction.
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Affiliation(s)
- Jaime A. Soto
- Fundación Nacional de Dermatologıa (FUNDERMA) y Hospital Dermatologico de Jorochito, Santa Cruz, Bolivia;,Address correspondence to Jaime A. Soto, Fundación Nacional de Dermatologıa (FUNDERMA) y Hospital Dermatologico de Jorochito, Santa Cruz, Bolivia. E-mail:
| | | | - Jonathan D. Berman
- Fast-Track Drugs and Biologics LLC, North Potomac, Maryland;,AB Foundation, North Bethesda, Maryland
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