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SARS-CoV-2 precipitating a stroke in a child? A case report from Tanzania.
Osman, Rukhsar Shabir; Dawood, Saliha Shafik; Thawer, Sheliza Parvez; Mandania, Shivangi Mukesh; Amirali, Mudassir Hussein; Bulimba, Maria Nathaniel; Walli, Nahida Zahir; Kija, Edward Nkingwa; Manji, Hussein Karim.
  • Osman RS; The Aga Khan Hospital, Dar-es-salaam, Tanzania.
  • Dawood SS; The Aga Khan Hospital, Dar-es-salaam, Tanzania.
  • Thawer SP; The Aga Khan Hospital, Dar-es-salaam, Tanzania.
  • Mandania SM; The Aga Khan Hospital, Dar-es-salaam, Tanzania.
  • Amirali MH; The Aga Khan Hospital, Dar-es-salaam, Tanzania.
  • Bulimba MN; The Aga Khan Hospital, Dar-es-salaam, Tanzania.
  • Walli NZ; The Aga Khan Hospital, Dar-es-salaam, Tanzania.
  • Kija EN; The Aga Khan Hospital, Dar-es-salaam, Tanzania.
  • Manji HK; Muhimbili University of Health and Allied Sciences, Dar-es-salaam, Tanzania.
Pan Afr Med J ; 42: 33, 2022.
Article in English | MEDLINE | ID: covidwho-1939419
ABSTRACT
There is scanty data on overall pediatric presentations with COVID-19 in sub-Saharan Africa and none reported related to stroke. Management of acute stroke in children has been challenging due to delays in presentation and difficulties in deducing the exact etiology. This is the first such case of a stroke in a child with COVID-19 infection reported in Tanzania to the best of our knowledge. A six-and-a-half-year-old male child of Asian origin with no history of chronic illness presented to our facility with fever, rash, gastrointestinal symptoms and conjunctivitis. Subsequently, he developed headache, irritability, altered mentation, loss of speech, facial nerve palsy and hemiparesis. He was provisionally diagnosed with bacterial meningitis with a differential diagnosis of viral encephalitis and received standard treatment for the same. On further investigations, magnetic resonance imaging (MRI) of the brain showed ischemic infarct along the territory of left middle cerebral artery and given the history of the child´s exposure to a relative with COVID-19 infection, child underwent a nasopharyngeal swab for polymerase chain reaction testing which was negative but the serum IgG for COVID was positive. Despite the severe presentation initially, early detection and appropriate management resulted in survival, regained speech and motor function. Due to constraints in health care systems in sub-Saharan Africa, it is difficult to exhaust the diagnostics in order to narrow down the list of differentials in a child with stroke. This case is reported to further describe the diverse presentations of COVID-19 particularly in children which has been under-represented especially in sub-Saharan Africa. Attending physicians should have a high index of suspicion for SARS-CoV-2 as the etiology for exposed children presenting with neurological symptoms.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Stroke / COVID-19 Type of study: Case report / Diagnostic study / Etiology study / Prognostic study Topics: Long Covid Limits: Child / Humans / Male Country/Region as subject: Africa Language: English Journal: Pan Afr Med J Year: 2022 Document Type: Article Affiliation country: Pamj.2022.42.33.33018

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Stroke / COVID-19 Type of study: Case report / Diagnostic study / Etiology study / Prognostic study Topics: Long Covid Limits: Child / Humans / Male Country/Region as subject: Africa Language: English Journal: Pan Afr Med J Year: 2022 Document Type: Article Affiliation country: Pamj.2022.42.33.33018