Masih Mike, Moll Sarah, Raza Naila
Paediatric Department, Wrexham Maelor Hospital, Wrexham, UK
Paediatric Department, Wrexham Maelor Hospital, Wrexham, UK.
BMJ Case Rep. 2020 Sep 15;13(9):e237194. doi: 10.1136/bcr-2020-237194.
The COVID-19 pandemic has created an unprecedented disease burden worldwide, affecting patients of all ages. Recently, there has been a rise in a new inflammatory condition termed paediatric multisystem inflammatory syndrome temporally associated with SARS-CoV-2 (PMIS-TS). We are yet to understand significant risk factors, disease progression and prognosis in children affected. We describe a case of a 9-year-old boy who tested positive concurrently for the SARS-CoV-2 virus 4 weeks apart. He presented with a 2-day history of fever, abdominal pain, headache and diarrhoea. Initial investigations supported PMIS-TS and he went on to develop atypical Kawasaki disease. With no results to differentiate between his positive results, we question whether he remained positive throughout or recovered with reactivation of the virus. There are reports of reactivation in adults but none in children. There are also no reports of children remaining positive for such a prolonged period, which raises public health concerns.
新冠疫情在全球造成了前所未有的疾病负担，影响着各个年龄段的患者。最近，一种名为儿童多系统炎症综合征（与SARS-CoV-2时间相关，PMIS-TS）的新型炎症性疾病有所增加。我们尚未了解受影响儿童的重大风险因素、疾病进展和预后情况。我们描述了一名9岁男孩的病例，他在相隔4周的时间里两次SARS-CoV-2病毒检测呈阳性。他出现了发热、腹痛、头痛和腹泻2天的病史。初步检查支持PMIS-TS诊断，随后他发展为非典型川崎病。由于两次阳性结果无法区分，我们质疑他是一直呈阳性还是病毒重新激活后康复。有关于成人病毒重新激活的报道，但儿童中尚无此类报道。也没有儿童长时间呈阳性的报道，这引发了公共卫生方面的担忧。
