Clinical and radiological findings for the new multisystem inflammatory syndrome in children associated with COVID-19.

The World Health Organization defines the multisystem inflammatory syndrome in children (MIS-C) as a new syndrome reported in patients aged <19 years old who have a history of exposure to SARS-CoV-2. The onset of this syndrome is characterized by persistent fever that is associated with lethargy, abdominal pain, vomiting and/or diarrhea, and, less frequently, rash and conjunctivitis. The course and severity of the signs and symptoms vary; in some children, MIS-C worsens rapidly and can lead to hypotension, cariogenic shock, or even damage to multiple organs. The characteristic laboratory findings are elevated markers of inflammation and heart dysfunction. The most common radiological findings are cardiomegaly, pleural effusion, signs of heart failure, ascites, and inflammatory changes in the right iliac fossa. In the context of the current COVID-19 pandemic, radiologists need to know the clinical, laboratory, and radiological characteristics of this syndrome to ensure the correct diagnosis.

[Clinical and radiological findings for the new multisystem inflammatory syndrome in children associated with COVID-19]. / Revisión de los hallazgos clínicos y radiológicos del nuevo síndrome inflamatorio multisistémico pediátrico vinculado a la COVID-19.

The World Health Organization defines the multisystem inflammatory syndrome in children (MIS-C) as a new syndrome reported in patients aged < 19 years old who have a history of exposure to SARS-CoV-2. The onset of this syndrome is characterized by persistent fever that is associated with lethargy, abdominal pain, vomiting and/or diarrhea, and, less frequently, rash and conjunctivitis. The course and severity of the signs and symptoms vary; in some children, MIS-C worsens rapidly and can lead to hypotension, cariogenic shock, or even damage to multiple organs. The characteristic laboratory findings are elevated markers of inflammation and heart dysfunction. The most common radiological findings are cardiomegaly, pleural effusion, signs of heart failure, ascites, and inflammatory changes in the right iliac fossa. In the context of the current COVID-19 pandemic, radiologists need to know the clinical, laboratory, and radiological characteristics of this syndrome to ensure the correct diagnosis.

[Progressive primary tuberculosis with endobronchial involvement. Benefits of multislice helical computed tomography]. / Tuberculosis primaria progresiva con afectación endobronquial. Aportación de la TC multicorte.

OBJECTIVES: To assess computed tomography (CT) imaging findings in progressive primary tuberculosis and to determine the use of the multislice images obtained. PATIENTS AND METHODS: We report the case of a 37-day-old infant admitted to hospital because of persistent fever despite antimicrobial therapy. Thoracic X-ray and multislice helical CT (CT Light speed i1.6 GE) were performed with 3-dimensional and virtual endoscopy reconstructions. RESULTS: CT showed mediastinal and hilar necrotic lymph nodes, pulmonary parenchymal involvement with miliary pattern, and multiple cavitated consolidations. Endobronchial involvement was clearly visualized by virtual endoscopy and was confirmed by fiberoptic bronchoscopy. CONCLUSIONS: Virtual endoscopy is a new, less invasive alternative radiological technique to fiberoptic bronchoscopy that may influence the management of patients with tuberculosis with endobronchial involvement.

Tuberculosis primaria progresiva con afectación endobronquial. Aportación de la TC multicorte / Progressive primary tuberculosis with endobronchial involvement. Benefits of multislice helical computed tomography

Objetivos: Describir los hallazgos de la forma progresiva de tuberculosis primaria y determinar la utilidad de las imágenes obtenidas por tomografía computarizada (TC) multicorte. Pacientes y métodos: Presentamos el caso de un lactante de 37 días de vida ingresado por fiebre persistente tras antibioterapia. Fue estudiado con radiografía de tórax y TC helicoidal multicorte (TC Light speed i1.6 GE) con posprocesado de las imágenes, reconstrucciones en tres dimensiones y endoscopia virtual. Resultados: La TC demuestra la presencia de masas adenopáticas mediastínicas e hiliares necrosadas, infiltrados pulmonares con patrón miliar y múltiples condensaciones cavitadas. La endoscopia virtual revela afectación endobronquial confirmada mediante fibrobroncoscopia. Conclusiones: La endoscopia virtual es una nueva técnica radiológica complementaria a la fibrobroncoscopia y menos invasiva que ésta, que puede influir en el tratamiento del paciente con afectación endobronquial por tuberculosis

Objectives: To assess computed tomography (CT) imaging findings in progressive primary tuberculosis and to determine the use of the multislice images obtained. Patients and methods: We report the case of a 37-day-old infant admitted to hospital because of persistent fever despite antimicrobial therapy. Thoracic X-ray and multislice helical CT (CT Light speed i1.6 GE) were performed with 3-dimensional and virtual endoscopy reconstructions. Results: CT showed mediastinal and hilar necrotic lymph nodes, pulmonary parenchymal involvement with miliary pattern, and multiple cavitated consolidations. Endobronchial involvement was clearly visualized by virtual endoscopy and was confirmed by fiberoptic bronchoscopy. Conclusions: Virtual endoscopy is a new, less invasive alternative radiological technique to fiberoptic bronchoscopy that may influence the management of patients with tuberculosis with endobronchial involvement