Atypical Kawasaki syndrome in COVID-19 infection: a case report of a multisystem inflammatory syndrome in a child (MIS-C)

The emergence of COVID-19 by a novel severe acute respiratory syndrome coronavirus (SARS-CoV-2) in 2019 has seen evolving data reporting infrequent infection in children and mostly mild disease for children who contract the infection. A severe form of COVID-19 in children recently reported in Europe and North America describes a multisystem inflammation syndrome in children (MIS-C), presenting as toxic-shock-like and Kawasaki-like syndromes. Data on MIS-C in Africa is being documented with recent reports from South Africa and Nigeria in black children, but information on MIS-C in Ghana is yet to be characterized. We report the first case of multisystem inflammatory syndrome in a child who tested PCR positive to SARS-CoV2 in a tertiary hospital in Ghana. The case describes a 10- year-old boy who reported Kawasaki-like syndrome without shock but with moderate respiratory distress requiring supportive acute care without the need for intensive care.

Factors Associated with Bacteraemia in Febrile; Non-Neonatal Children 5 Years Old at the Paediatric Outpatient Clinic of the University of Port Harcourt Teaching Hospital; Nigeria

Background. Fever is one of the most common presenting symptoms in the emergency room. Bacteraemia can be a cause of febrile illness in children and can have a fatal outcome if untreated. Therefore; it is important to identify factors associated with bacteraemia in febrile children in order to aid its early diagnosis and prompt treatment. Objectives. To determine the factors associated with bacteraemia among febrile; non-neonatal; under-five children seen in the Children's Clinic of the University of Port Harcourt Teaching Hospital; Nigeria. Methods. Febrile children aged 29 days - 59 months who presented at the outpatient clinic and whose parents gave consent were recruited between September 2010 and January 2011. Information on their age; gender; weight; symptoms; physical examination and blood culture results was collected and analysed.Results. A total of 362 children were studied. The prevalence rate of bacteraemia was 11.5% and 22.2% in moderately and severely malnourished children; respectively (p=0.010). Children with systemic inflammatory response syndrome (SIRS) had the highest bacteraemia prevalence rate (66.7%; p0.001); while children with focal infection and children with fever without other symptoms or signs had bacteraemia rates of 7.1% and 3.7%; respectively. There was no significant relationship between the magnitude of fever and bacteraemia (p0.050).Conclusion. Blood cultures should be performed in febrile children who are malnourished or who have SIRS. Antibiotics should also be commenced while blood culture results are awaited