tetano
Editor, Senior Moderator
Ital J Pediatr
. 2021 Jun 2;47(1):120.
doi: 10.1186/s13052-021-01070-z.
A fatal toxic shock-like syndrome post COVID-19 infection in a child
Houda Ajmi[SUP] 1 [/SUP], Wissem Besghaier[SUP] 2 [/SUP], Wafa Kallala[SUP] 3 [/SUP], Abdelhalim Trabelsi[SUP] 3 [/SUP], Saoussan Abroug[SUP] 2 [/SUP]
Affiliations
Abstract
Background: Children affected by Coronavirus disease 2019 (COVID-19) showed various manifestations. Some of them were severe cases presenting with multi-system inflammatory syndrome (MIS-C) causing multiple organ dysfunction.
Case presentation: We report the case of a 12-year-old girl with recent COVID-19 infection who presented with persistent fever, abdominal pain and other symptoms that meet the definition of MIS-C. She had lymphopenia and a high level of inflammatory markers. She was admitted to pediatric intensive care unit since she rapidly developed refractory catecholamine-resistant shock with multiple organ failure. Echocardiography showed a small pericardial effusion with a normal ejection fraction (Ejection Fraction = 60%) and no valvular or coronary lesions. The child showed no signs of improvement even after receiving intravenous immunoglobulin, fresh frozen plasma, high doses of Vasopressors and corticosteroid. His outcome was fatal.
Conclusion: Pediatric patients affected by the new COVID-19 related syndrome may show severe life-threatening conditions similar to Kawasaki disease shock syndrome. Hypotension in these patients results from heart failure and the decreased cardiac output. We report a new severe clinical feature of SARS-CoV-2 infection in children in whom hypotension was the result of refractory vasoplegia.
Keywords: Child; Coronavirus infection; Multi-system inflammatory syndrome; TSS: toxic shock syndrome; Toxic shock syndrome.
. 2021 Jun 2;47(1):120.
doi: 10.1186/s13052-021-01070-z.
A fatal toxic shock-like syndrome post COVID-19 infection in a child
Houda Ajmi[SUP] 1 [/SUP], Wissem Besghaier[SUP] 2 [/SUP], Wafa Kallala[SUP] 3 [/SUP], Abdelhalim Trabelsi[SUP] 3 [/SUP], Saoussan Abroug[SUP] 2 [/SUP]
Affiliations
- PMID: 34078429
- DOI: 10.1186/s13052-021-01070-z
Abstract
Background: Children affected by Coronavirus disease 2019 (COVID-19) showed various manifestations. Some of them were severe cases presenting with multi-system inflammatory syndrome (MIS-C) causing multiple organ dysfunction.
Case presentation: We report the case of a 12-year-old girl with recent COVID-19 infection who presented with persistent fever, abdominal pain and other symptoms that meet the definition of MIS-C. She had lymphopenia and a high level of inflammatory markers. She was admitted to pediatric intensive care unit since she rapidly developed refractory catecholamine-resistant shock with multiple organ failure. Echocardiography showed a small pericardial effusion with a normal ejection fraction (Ejection Fraction = 60%) and no valvular or coronary lesions. The child showed no signs of improvement even after receiving intravenous immunoglobulin, fresh frozen plasma, high doses of Vasopressors and corticosteroid. His outcome was fatal.
Conclusion: Pediatric patients affected by the new COVID-19 related syndrome may show severe life-threatening conditions similar to Kawasaki disease shock syndrome. Hypotension in these patients results from heart failure and the decreased cardiac output. We report a new severe clinical feature of SARS-CoV-2 infection in children in whom hypotension was the result of refractory vasoplegia.
Keywords: Child; Coronavirus infection; Multi-system inflammatory syndrome; TSS: toxic shock syndrome; Toxic shock syndrome.