ABSTRACT
Introduction. Coronavirus disease 2019 (COVID-19) frequently leads to asymptomatic or mild infectious disease evolution in children. Case presentation. We present the case of a 3 year old girl, known with acute lymphoblastic leukemia in chemother-apy treatment at that time. She had an asymptomatic form of COVID-19 but with important paraclinical changes. The evolution was favorable under the treatment initiated with antibiotics, corticotherapy, gastric protector and symptomatic treatment if necessary. Conclusion. Management of children with COVID-19 and other comorbidities remains a challenge given the few data currently in the literature. © 2021, Amaltea Medical Publishing House. All rights reserved.
ABSTRACT
A female child, 1 year-old and 2 months, diagnosed with multiple neurological conditions, including myelomeningocele and operated hydrocephalus, was diagnosed with SARS-CoV-2 in October 2020 and hospitalized in our clinic. At the time of the onset of the disease, the patient had a febrile episode, laboratory blood tests showed a slightly increased biologi-cal inflammatory syndrome, and mixed pneumonia was described radiologically. Thus, antibiotic treatment was initiated, with laboratory tests and control imaging within normal limits after several days of admission. Being an institutionalized child, according to the epidemiological recommendations of that time, she was hospitalized in our clinic during the 14 days of the illness. Thus, on the 15th day of the disease she was discharged, with negative SARS-CoV-2 control RT-PCR, with good general condition, afebrile over 10 days. © 2021, Amaltea Medical Publishing House. All rights reserved.
ABSTRACT
Introduction. SARS-CoV-2 virus infection affects all age groups. In children, the infection mainly causes asympto-matic or mildly symptomatic forms of the disease, regardless of their immune status. Case presentation. We describe the case of a 7-year-old male child, known to have Fanconi anemia, scheduled for bone marrow transplantation. The patient comes from a family outbreak of COVID-19, which is why he was tested for SARS-CoV-2 infection. He is asymptomatic at the time of admission to our clinic. The clinical examination performed at the time of admission shows a patient in good general condition, afebrile, with pale skin and mucous membranes, without respiratory changes. Paraclinically, severe neutropenia, severe normochromic normocytic anemia and severe thrombocytopenia are detected, for which transfusions of erythrocyte mass and platelet mass are performed. Due to the immunocompromised status, antibiotic therapy is instituted. If necessary, symptomatic treatment is administered. The evolution is favorable, and the SARS-CoV-2 RT-PCR control test is negative on the eighth day of hospitalization. Conclusions. Immunocompromised status is not a major risk factor for severe COVID-19 in children. © 2021, Amaltea Medical Publishing House. All rights reserved.
ABSTRACT
Introduction. COVID-19 is associated with a significant incidence of bacterial and fungal superinfections and with the exacerbation of pre-existing infections, representing a diagnostic and therapeutic challenge. Case presentation. A 64-year-old woman, confirmed with COVID-19 by the SARS-CoV-2 antigen test, is hospitalized accusing fatigue, nausea, watery stools, cough and vertigo started 10 days ago, aggravated 4 days before the pres-entation. It also reports recurrent episodes of otalgia and otorrheic pluriantibiotic treatment in the last 2 months. From the personal pathological antecedents we remember: hypothyroidism, dyslipidemia, hypertension, ischemic heart disease, history of deep vein thrombosis (DVT) and secondary pulmonary thromboembolism, in chronic anticoagulant treatment. Pathological clinical signs at admission: bilateral basal crackling rales. Biologically, inflam-matory syndrome is detected, and radiologically, interstitial-alveolar infiltrates in the lower lung fields. On day 3 of hospitalization, the patient shows purulent secretion in the right external auditory canal and the ENT consultation confirms chronic suppurative otitis media in acute onset. Bacteriological examination of otic secretion reveals As-pergillus niger. Antiviral treatment with Remdesivir is initiated, antibiotic therapy initiated at home with Azithro-mycin is continued for one day, then escalated to Ceftriaxone i.v. (in the context of clinical-paraclinical aggravation), systemic corticotherapy, anticoagulation with Dalteparin in the prophylactic regime of DVT, systemic treatment with Voriconazole p.o. (according to the antifungal program) and topical (local) with a slow favorable evolution. Conclusions. The association of COVID-19 with otitis with Aspergillus is a rare and particular clinical picture. © 2021, Amaltea Medical Publishing House. All rights reserved.
ABSTRACT
Introduction. Although SARS-CoV-2 infection is more common in adults, many cases have been reported in the pediatric population. Case presentation. An 8-month-old infant from twin pregnancy, confirmed with COVID-19, is hospitalized with nasal obstruction, serous rhinorrhea, rare cough and watery stools. The epidemiological link is known, both the parents and the maternal grandparents of the infant being confirmed with COVID-19. Biologically, he presented with thrombocytosis and discrete inflammatory syndrome, and the lung radiograph did not show any lesions. At the same time, the twin sister was hospitalized, who presented a similar symptomatol-ogy, with a negative SARS-CoV-2 PCR test, but the lung radiograph showed specific lesions of COVID-19. During hospitalization, 2 more SARS-CoV-2 PCR tests were performed, but with negative results. The evolution of the twins was favorable under symptomatic treatment, respectively antibiotic and symptomatic treatment. Conclusion. SARS-CoV-2 infection may be asymptomatic, especially in infants and newborns, and has a lower prevalence. © 2021, Amaltea Medical Publishing House. All rights reserved.
ABSTRACT
In this retrospective unicenter study we aimed to outline the key features of the first 100 cases of COVID-19 hospitalized in our clinic after designation of it as front line unit for hospitalization of these cases. Thus, the average age of cases was 44.7 years (SD: 15.9) and the prevalence of female was 57.4%. By age groups, prevalence of young patients (7.8%) was significantly (p < 0.05) lower than the prevalence of adult patients (77.2%). The most prevalent occupation (31.7%) was healthcare worker. The most frecvent exposure to source of infection was represented by attending healthcare facilities (44.6%), followed by having contact with COVID-19 confirmed/suspect case (30.7%), and recent international travel (18.8%). Of the 30% of cases in which at least one health precondition was recorded the most prevalent (13.9%) of such condition was chronic cardiovascular disease including high blood presure. In regard with severity, to note that 6 patients died within 14 days of hospital admission, all fatalities have occurred in very old patients and 83.3% of them had chronic kidney disease. In the end, we express the hope that data outlined in this paper will help for better management of COVID-19 pandemic. © 2020, Amaltea Medical Publishing House. All rights reserved.
ABSTRACT
The ongoing coronavirus disease 2019 (COVID-19) outbreak was declared a pandemic by the World Health organization in early March 2020. The disease typically presents with viral respiratory symptoms that could progress to acute respiratory dis-tress syndrome. Emerging evidence suggests different possible dermatologic manifestations of COVID-19, including: acral lesions (pernio-like, pseudo-chillblain), vesicular eruptions, macular and papular exanthema, urticaria, livedoid, purpuric and petechial rashes. However, specific skin manifestations of the COVID-19 disease have not yet been clearly established and the relationship between the appearance of skin lesions and SARS-CoV-2 infection is still unclear. These highly variable skin changes could represent a direct con-sequence of the viral infection, an immunological response to viral nucleotides, adverse reactions to drugs frequently used for the treatment of COVID-19, or other disorders. In a global effort to comprehend the exact cutaneous features of COVID-19, several international dermatological societies have initiated nationwide studies to analyze COVID-19 cutaneous manifestations during this pandemic. This paper represents a literature review of the scientific data available on the clinical characteristics and symptoms of the cutaneous manifestations associated with COVID-19. Such findings are extremely useful in establishing if dermatological manifestations in COVID-19 patients could harbor a diagnostic significance and subsequently be used as prognostic factors for outcomes of COVID-19. © 2020, Amaltea Medical Publishing House. All rights reserved.
ABSTRACT
The COVID-19 pandemic has challenged the medical world in many ways regarding diagnosis troubles and therapeutic options. In this paper, we will present three cases of patients from different age groups, in which we identified specific ways of evolution, from both clinically and laboratory data point of view. We used a critical evolution risk estimation calculator at admission and compared the results with the subsequent evolution of patients. From the analysis of the presented cases, we found persistent organic damage that will require their long-term follow-up. © 2020, Amaltea Medical Publishing House. All rights reserved.
ABSTRACT
In March 2020, the first patients diagnosed with COVID-19 were hospitalized in the Infectious and Tropical Diseases Clinical Hospital „Dr. Victor Babes“. Of the 20 patients, 11 were male and 9 were female. Patients were aged between 3 to 56 years. 8 patients traveled outside Romania during the incubation period of the disease. The most common symptom cluster encompassed the respiratory system: fever, cough and shortness of breath. 2 patients presented severe forms of disease that required transfer to the intensive care unit. Radiologically, 18 patients had interstitial lung damage. All patients had a favorable evolution. © 2020, Amaltea Medical Publishing House. All rights reserved.
ABSTRACT
Currently, SARS-CoV-2 infection has affected the entire population of the globe, registering an alarming increase in the number of cases, but also in deaths. The main clinical expression of COVID-19 is pneumonia, for its evaluation being necessary an imaging characterization of lung lesions both by chest radiography and by computed tomography (CT) of the chest. Vari-ous studies performed on groups of patients revealed that CT examination is more accurately in diagnosing lung lesions at the onset of symptoms, but also before it. The most common lesions were multiple, bilateral, peripheral, in the lower lung fields. The appearance often varies between alveolar consolidation and ground-glass. Also, the data from the relevant studies emphasize the possibility of the existence of early pathological aspects on CT acquisitions, which do not involve clinical expression. Thus, it can be stated that both investi-gations are crucial in assessing the impact of the new coronavirus infection on the lung parenchyma, but also in guiding therapeutic management. © 2020, Amaltea Medical Publishing House. All rights reserved.