Contained Jejunal Perforation Secondary to Ingestion of Magnet Balls in a Nonfatal Drowning Child.

Most ingested foreign bodies often pass through the gastrointestinal tract uneventfully; however, complications such as perforation do occur. Jejunal perforation is a known complication of abdominal trauma. While gastrointestinal tract injury due to the ingested foreign body such as a toothpick, fishbone, and battery among others are common, jejunal perforation is not very common in pediatrics. We report an unusual case of jejunal perforation that was diagnosed after a child was admitted to the pediatric intensive care unit for nonfatal drowning. A 15-month-old girl presented to our emergency room after she was found submerged in a swimming pool. She was unwitnessed for about ten minutes. At the scene, she was apneic, and cyanotic but had a pulse. Cardiopulmonary resuscitation was started and she was brought to our emergency room. She was managed for her drowning injuries and was accidentally found to have a foreign body on her abdomen by x-ray. She had no signs or symptoms of perforation, however, after questioning the parents they told us that they brought her a toy containing magnet balls about one month ago. After stabilizing her respiratory status and correcting her acidosis, an upper gastrointestinal (GI) endoscopy was done that showed jejunal perforation and multiple magnets. A consultation was done immediately for the pediatric surgery team then the perforation was repaired. High-powered magnets represent a serious health hazard if ingested due to risks of gastrointestinal perforation. It is important to have a high index of suspicion for potential injuries, especially silent ones. One of the rare complications is contained jejunal perforation.

Clustering of Covid-19 infections among healthcare workers: Experience from a tertiary care center in Saudi Arabia.

INTRODUCTION: Coronavirus infectious disease 2019 (COVID-19) had a significant impact on healthcare workers (HCWs) worldwide. Understanding the dynamics of infection transmission is important to develop strategies to prevent its spread. METHODS: A retrospective study of a cohort of HCWs with COVID-19 from a single tertiary care hospital during the first wave of the pandemic. Epidemiological investigations and identification of clusters of infection were done prospectively. RESULTS: A total of 326 HCWs had COVID-19 based on positive polymerase chain reaction tests for SARS-CoV-2. Ten clusters of infection were identified; nine clusters had HCWs as the index cases while one cluster had a patient as the index case. The largest cluster involved 15 transmissions, and one cluster included a secondary transmission. Sharing accommodation and social gatherings were the commonest epidemiological links. The majority of infected HCWs had mild infections, 23 (6%) required hospital admission and 3 (1%) required intensive care; all fully recovered. Majority of infections (80%) were community-acquired. Living in shared accommodation was associated with COVID-19 (120/690 versus 206/1610, P value = .01) while working in COVID-19 designated wards/units was not associated with COVID-19 (52/297 vs 274/2003, P value = .13). CONCLUSIONS: Clustering of COVID-19 was common among HCWs and related to shared accommodation and social gatherings, infection was of mild severity, and was not associated with caring for COVID-19 patients.

Multisystem Inflammatory Syndrome in Children, the Real Disease of COVID-19 in Pediatrics - A Multicenter Case Series From Al-Ahsa, Saudi Arabia.

Fortunately, coronavirus disease 2019 (COVID-19) infection in pediatric populations exhibits a mild course of disease. However, a small number have recently been identified who develop a significant systemic inflammatory response, a new disease entity called multisystem inflammatory syndrome in children (MIS-C), especially after the peak of the wave in Al-Ahsa, Saudi Arabia, in early June to mid-July. In MIS-C children usually present a few days to a few weeks after recovery from COVID-19 with high grade fever, GI symptoms, Kawasaki-like picture or even toxic shock-like syndrome. Raising awareness about this disease entity is very fundamental to enable pediatricians and other health care providers to identify and manage these patients before it is too late. We describe 10 different cases of MIS-C with different risk factors and presentations.