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A 6-Year-Old Boy with COVID-19-Positive Pleural Effusion and Kawasaki-Like Features

Sedigheh Yousefzadegan1, Ramin Zare Mahmoudabadi2, Golnaz Gharehbaghi3

  • 1Department of Pediatric Pulmonology, Firoozabadi Clinical Research Development Unit (FACRDU), Iran University of Medical Sciences, Tehran, Iran.

Case Reports in Pediatrics
|April 5, 2021
PubMed

Insights

This study reports the first pediatric case of COVID-19-positive pleural fluid in a 6-year-old boy. The patient presented with respiratory distress and multisystem inflammatory syndrome, highlighting atypical COVID-19 presentations in children.

Area of Science:

  • Pediatric infectious diseases
  • Pulmonology
  • Critical care medicine

Background:

  • The novel coronavirus (SARS-CoV-2) causes COVID-19, affecting patients globally.
  • Pleural effusions are considered atypical manifestations of COVID-19.
  • Multisystem inflammatory syndrome in children (MIS-C) is a serious complication of COVID-19.

Observation:

  • A 6-year-old boy presented with respiratory distress, bilateral pleural effusions, and symptoms consistent with MIS-C.
  • The patient tested positive for COVID-19 IgG antibodies via ELISA.
  • SARS-CoV-2 was detected in the pleural fluid via RT-PCR.

Findings:

  • This case represents the first documented instance of COVID-19-positive pleural fluid in a pediatric patient.
  • The findings suggest that SARS-CoV-2 can directly infect the pleura in children, leading to effusion.
  • The co-occurrence of pleural effusion and MIS-C in this pediatric case warrants further investigation.

Implications:

  • This case expands the spectrum of respiratory manifestations of COVID-19 in children.
  • It underscores the importance of considering COVID-19 in pediatric patients with unexplained pleural effusions and inflammatory syndromes.
  • Further research is needed to understand the pathogenesis and clinical significance of SARS-CoV-2 in pediatric pleural effusions.

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