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A fatal toxic shock-like syndrome post COVID-19 infection in a child.
Ajmi, Houda; Besghaier, Wissem; Kallala, Wafa; Trabelsi, Abdelhalim; Abroug, Saoussan.
  • Ajmi H; Department of Pediatrics, Sahloul University Hospital, 4054, Sousse, Tunisia. hd.ajmi@gmail.com.
  • Besghaier W; Department of Pediatrics, Sahloul University Hospital, 4054, Sousse, Tunisia.
  • Kallala W; Department of Virology, Sahloul University Hospital, 4054, Sousse, Tunisia.
  • Trabelsi A; Department of Virology, Sahloul University Hospital, 4054, Sousse, Tunisia.
  • Abroug S; Department of Pediatrics, Sahloul University Hospital, 4054, Sousse, Tunisia.
Ital J Pediatr ; 47(1): 120, 2021 Jun 02.
Article in English | MEDLINE | ID: covidwho-1255952
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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Systemic Inflammatory Response Syndrome / COVID-19 Type of study: Case report / Diagnostic study / Prognostic study Topics: Long Covid Limits: Child / Female / Humans Language: English Journal: Ital J Pediatr Journal subject: Pediatrics Year: 2021 Document Type: Article Affiliation country: S13052-021-01070-z

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Systemic Inflammatory Response Syndrome / COVID-19 Type of study: Case report / Diagnostic study / Prognostic study Topics: Long Covid Limits: Child / Female / Humans Language: English Journal: Ital J Pediatr Journal subject: Pediatrics Year: 2021 Document Type: Article Affiliation country: S13052-021-01070-z