Acute Mild Pancreatitis Following COVID-19 mRNA Vaccine in an Adolescent.

A 17-year-old male was referred to the emergency room with sharp abdominal pain, pallor, sweating, and vomiting 12 h after the administration of his first Pfizer-BioNTech vaccine for coronavirus disease 2019 (COVID-19). He had abdominal pain, an increase in serum lipase value of > 3 times the upper limits of normal, and magnetic resonance imaging (MRI) findings consistent with acute mild pancreatitis (AP). He was started on treatment with fluid therapy and non-steroidal anti-inflammatory drugs for pain management, after which he recovered rapidly and was discharged on the fourth day after hospitalization. The available data are difficult to interpret as AP is a relatively frequent disease, but its occurrence after vaccination seems extremely rare. Although it is a rare event, AP should be considered after COVID-19 vaccination, especially in those exhibiting abdominal tenderness and vomiting, which should be promptly treated and adequately investigated.

COVID-19 and children with Down syndrome: is there any real reason to worry? Two case reports with severe course.

BACKGROUND: Down syndrome (DS) is characterized by a series of immune dysregulations, of which interferon hyperreactivity is important, as it is responsible for surging antiviral responses and the possible initiation of an amplified cytokine storm. This biological condition is attributed to immune regulators encoded in chromosome 21. Moreover, DS is also characterized by the coexistence of obesity and cardiovascular and respiratory anomalies, which are risk factors for coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). CASE PRESENTATION: A total of 55 children were admitted to the pediatric ward in Bergamo, between February and May 2020 for COVID-19. Here, we describe the cases of two children with DS and a confirmed COVID-19 diagnosis who had a severe course. In addition, both cases involved one or more comorbidities, including cardiovascular anomalies, obesity, and/or obstructive sleep apnea. CONCLUSIONS: Our observations indicate that children with DS are at risk for severe COVID-19 disease course.

Pneumonia in a Teenager Hiding a Fire-Eating Stunt.

Pneumonia in children due to hydrocarbon aspiration is usually the result of an uncommon accidental event. However, an acute and severe type of pneumonia induced by hydrocarbon aspiration is occasionally experienced by entertainers known as fire-eaters. Different approaches to treat fire-eater's pneumonia appear in the literature. Although there is no consensus regarding the management of this condition, the use of antibiotic therapy is well recognized and recommended by some, whereas others recommend only supportive treatment. Steroids are indicated in severe cases.Here, we report the case of a boy who developed severe pneumonia after inhaling hydrocarbons during an attempt to mimic a fire-eater show. Slow resolution was achieved after broad-spectrum antibiotic therapy in addition to systemic and inhaled steroids and physiotherapy.