Fever with Rash is One of the First Presentations of COVID-19 in Children: A Case Report
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Journal: 2020/August - International Medical Case Reports Journal
Abstract:
Introduction: Clinical presentations of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vary among patients, which make a confusing challenge for clinicians to diagnose the disease. While the disease is not rare, but the symptoms may be atypical in children.
Case presentation: A 12-month-old boy with fever and rash without respiratory complaints at the onset of the disease presented to the hospital. His illness was then accompanied by severe anemia, hypoalbuminemia, hypoxemia, and pleural effusion. The nasopharyngeal swab polymerase chain reaction test was positive for the novel coronavirus. Despite primary normal lung imaging, the second imaging was typical for the disease on the third day of admission.
Discussion: Dermatologic manifestations of the novel coronavirus infection are not rare during the illness but rarely occur at the onset of the disease. Information about the cutaneous manifestations of SARS-CoV-2 and its time interval from the onset of the disease in children are not clear yet. Severe anemia, hypoalbuminemia, and pleural effusion are not reported as classic findings of the novel SARS-CoV-2. They may be considered as a consequence of the hyperinflammatory response or direct effect of the virus.
Conclusion: As a different manifestation of SARS-CoV-2, infected children may initially present fever and rash. More studies are needed to discover the cause of these complications. The correct answer may lead to better insight and more effective treatment.
Keywords: COVID-19; SARS-CoV-2; children; fever; rash.
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Int Med Case Rep J 13: 335-340
PMID: 32821174

Fever with Rash is One of the First Presentations of COVID-19 in Children: A Case Report

Pediatric Infectious Diseases Research Center, Mazandaran University of Medical Sciences, Sari, Iran
Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
Pediatric Department, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
Correspondence: Mohammad Sadegh Rezai Bu-Ali Sina Hospital, Mazandaran University of Medical Sciences, Sari, Iran, Email drmsrezaii@yahoo.com
Received 2020 May 15; Accepted 2020 Jul 10.
Copyright © 2020 Navaeifar et al.
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Abstract

Introduction

Clinical presentations of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vary among patients, which make a confusing challenge for clinicians to diagnose the disease. While the disease is not rare, but the symptoms may be atypical in children.

Case Presentation

A 12-month-old boy with fever and rash without respiratory complaints at the onset of the disease presented to the hospital. His illness was then accompanied by severe anemia, hypoalbuminemia, hypoxemia, and pleural effusion. The nasopharyngeal swab polymerase chain reaction test was positive for the novel coronavirus. Despite primary normal lung imaging, the second imaging was typical for the disease on the third day of admission.

Discussion

Dermatologic manifestations of the novel coronavirus infection are not rare during the illness but rarely occur at the onset of the disease. Information about the cutaneous manifestations of SARS-CoV-2 and its time interval from the onset of the disease in children are not clear yet. Severe anemia, hypoalbuminemia, and pleural effusion are not reported as classic findings of the novel SARS-CoV-2. They may be considered as a consequence of the hyperinflammatory response or direct effect of the virus.

Conclusion

As a different manifestation of SARS-CoV-2, infected children may initially present fever and rash. More studies are needed to discover the cause of these complications. The correct answer may lead to better insight and more effective treatment.

Keywords: SARS-CoV-2, COVID-19, fever, rash, children
Abstract

References

  • 1. Ng O-T, Marimuthu K, Chia P-Y, et al. SARS-CoV-2 infection among travelers returning from Wuhan, China. N Engl J Med. 2020;382(15):1476–1478. doi:10.1056/NEJMc2003100 ] [
  • 2. de Groot RJ, Baker SC, Baric RS, et al. Commentary: Middle East respiratory syndrome coronavirus (MERS-CoV): announcement of the Coronavirus Study Group. J Virol. 2013;87(14):7790–7792. doi:10.1128/JVI.01244-13 ] [
  • 3. Zaki AM, Van Boheemen S, Bestebroer TM, Osterhaus ADME, Fouchier RAM. Isolation of a novel coronavirus from a man with pneumonia in Saudi Arabia. N Engl J Med. 2012;367(19):1814–1820. doi:10.1056/NEJMoa1211721 [] [[PubMed]
  • 4. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. lancet. 2020;395(10223):497–506. doi:10.1016/S0140-6736(20)30183-5 ] [
  • 5. Cai J, Xu J, Lin D, et al. A Case Series of children with 2019 novel coronavirus infection: clinical and epidemiological features. Clin Infect Dis. 2020.
  • 6. Henry D, Ackerman M, Sancelme E, Finon A, Esteve E. Urticarial eruption in COVID-19 infection. J Eur Acad Dermatol Venereol. 2020;34(6). doi:10.1111/jdv.16472 ] [
  • 7. Xia W, Shao J, Guo Y, Peng X, Li Z, Hu D. Clinical and CT features in pediatric patients with COVID-19 infection: different points from adults. Pediatr Pulmonol. 2020;55(5):1169–1174. doi:10.1002/ppul.24718 ] [
  • 8. Rahimzadeh G, Ekrami Noghabi M, Kadkhodaei Elyaderani F, et al. COVID-19 infection in Iranian children: a case series of 9 patients. J Pediatr Rev. 2020;8(2):139–144. doi:10.32598/jpr.8.2.139 [[PubMed]
  • 9. Recalcati S. Cutaneous manifestations in COVID-19: a first perspective. J Eur Acad Dermatol Venereol. 2020;34(5). doi:10.1111/jdv.16387 [] [[PubMed]
  • 10. Jones VG, Mills M, Suarez D, et al. COVID-19 and kawasaki disease: novel virus and novel case. Hosp Pediatr. 2020;hpeds:2020–2123. [[PubMed]
  • 11. Riphagen S, Gomez X, Gonzalez-Martinez C, Wilkinson N, Theocharis P. Hyperinflammatory shock in children during COVID-19 pandemic. lancet. 2020;395(10237):1607–1608. doi:10.1016/S0140-6736(20)31094-1 ] [
  • 12. Galván CC, Català A, Carretero HG, et al. Classification of the cutaneous manifestations of COVID −19: a rapid prospective nationwide consensus study in Spain with 375 cases. Br J Dermatol. 2020;183(1):71–77. doi:10.1111/bjd.19163 ] [
  • 13. Estébanez A, Pérez‐Santiago L, Silva E, Guillen‐Climent S, García‐Vázquez A, Ramón MD. Cutaneous manifestations in COVID-19: a new contribution. J Eur Acad Dermatol Venereol. 2020;34(6). doi:10.1111/jdv.16474 ] [
  • 14. Landa N, Mendieta‐Eckert M, Fonda‐Pascual P, Aguirre T. Chilblain-like lesions on feet and hands during the COVID-19 pandemic. Int J Dermatol. 2020;59(6):739–743. doi:10.1111/ijd.14937 ] [
  • 15. Chesser H, Chambliss JM, Zwemer E. Acute hemorrhagic edema of infancy after coronavirus infection with recurrent rash. Case Rep Pediatr. 2017;2017.
  • 16. Saad M, Omrani AS, Baig K, et al. Clinical aspects and outcomes of 70 patients with Middle East respiratory syndrome coronavirus infection: a single-center experience in Saudi Arabia. Int J Infect Dis. 2014;29:301–306. doi:10.1016/j.ijid.2014.09.003 ] [
  • 17. Bernheim A, Mei X, Huang M, et al. Chest CT Findings in Coronavirus Disease-19 (COVID-19): relationship to duration of infection. Radiology. 2020;295(3):200463. doi:10.1148/radiol.2020200463 ] [
  • 18. Ng M-Y, Lee EY, Yang J, et al. Imaging profile of the COVID-19 infection: radiologic findings and literature review. Radiology. 2020;2(1):e200034. [PubMed]
  • 19. Bwire GM, Paulo LS. Coronavirus disease-2019: is fever an adequate screening for the returning travelers?Trop Med Health. 2020;48(1):1–3. doi:10.1186/s41182-020-00201-2 ] [
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