Pediatric Brucellosis: A Challenging Diagnosis-Case Report.

BACKGROUND: Brucellosis is the second most widely spread zoonotic disease. There is less literature on this disease in Pakistan, leading to delayed diagnosis, or the patient remains undiagnosed. This study aims to contribute to Pediatric brucellosis literature, epidemiological, clinical features, laboratory findings, and treatment. CASE PRESENTATION: We present an 11-year-old child who was admitted to the hospital due to abdominal pain for one month and a fever for 15 days. On abdominal ultrasound, she had hepato-splenomegaly with minimal pleural effusion. A comprehensive diagnostic workup for infectious and immunologic disorders confirmed brucellosis with the antibody tests report. She received doxycycline, rifampin, and trimethoprim-sulfamethoxazole for three months. The treatment was continued with Syrup Doxycycline (50 mg/5 ml), and Syrup Rifampicin (2 g/100 ml) was prescribed for five weeks. Her symptoms were improved by the end of the treatment. CONCLUSION: Brucella is an intracellular pathogen affecting multi-systems of the human body; thus, the treatment is started with antimicrobials that have penetrative effects on a cell. The treatment can be adjusted based on the age group and the complication of the symptoms.

Incidental Finding of Coronary Artery Dilatation in Children With History of COVID-19 Having Minimal or No Symptoms: Raising Red Flag.

Coronary artery dilatation has been observed with coronavirus disease 2019 (COVID-19)-associated multisystem inflammatory syndrome in children (MIS-C), which is more common in those with Kawasaki-like disease. MIS-C is a clinical syndrome in children and adolescents; its signs and symptoms, as well as cardiac manifestations, are similar to Kawasaki diseases, such as coronary artery dilation, coronary aneurysms, and ventricular dysfunction. The occurrence of coronary artery dilatation in asymptomatic pediatric patients following COVID-19 infection has not been well documented in the literature. Thus, in this article, we present four cases of coronary artery dilation in children with a past history of COVID-19 infection who had very few or no symptoms and were referred to us for vague chest pain and palpitation. As a result, a high index of suspicion is required, and any patient complaining of chest pain and palpitation with a history of COVID-19 exposure should not be ignored and be given proper coronary artery evaluation. This article also raises the question of whether every child infected with COVID-19 should have an echocardiogram.