1. Terminal Ileitis as the Exclusive Manifestation of COVID-19 in Children.
- Author
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Schuler, Lea Maria, Falkensammer, Barbara, Orlik, Peter, Auckenthaler, Michael, Kranewitter, Christof, Bante, David, von Laer, Dorothee, and Fink, Franz-Martin
- Subjects
SYMPTOMS ,SARS-CoV-2 Omicron variant ,MULTISYSTEM inflammatory syndrome in children ,YOUNG adults ,CAMPYLOBACTER jejuni - Abstract
The clinical presentation, organ involvement, and severity of disease caused by SARS-CoV-2 are highly variable, ranging from asymptomatic or mild infection to respiratory or multi-organ failure and, in children and young adults, the life-threatening multisystemic inflammatory disease (MIS-C). SARS-CoV-2 enters cells via the angiotensin-converting enzyme-2 receptor (ACE-2), which is expressed on the cell surfaces of all organ systems, including the gastrointestinal tract. GI manifestations have a high prevalence in children with COVID-19. However, isolated terminal ileitis without other manifestations of COVID-19 is rare. In March 2023, two previously healthy boys (aged 16 months and 9 years) without respiratory symptoms presented with fever and diarrhea, elevated C-reactive protein levels, and low procalcitonin levels. Imaging studies revealed marked terminal ileitis in both cases. SARS-CoV-2 (Omicron XBB.1.9 and XBB.1.5 variants) was detected by nucleic acid amplification in throat and stool samples. Both patients recovered fast with supportive measures only. A differential diagnosis of acute abdominal pain includes enterocolitis, mesenteric lymphadenitis, appendicitis, and more. During SARS-CoV-2 epidemics, this virus alone may be responsible for inflammation of the terminal ileum, as demonstrated. Coinfection with Campylobacter jejuni in one of our patients demonstrates the importance of a complete microbiological workup. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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