Search

Cerebral sinovenous thrombosis (CSVT) is a rare, but potentially serious condition among children which requires a multidisciplinary team approach. Clinical manifestations of CSVT include: headache, vomiting, photophobia, blurred vision, focal or generalized seizures, motor deficits, altered mental status and coma. Objective: Exposure clinical data, laboratory and management in cerebral venous thrombosis in children- a clinical case report. Material and methods. We present a case of 14 months - old boy, admitted in ICU National Institute for Infectious diseases "Prof. Matei Bals" for: fever, vomiting, focal and generalized seizures, right hemiparesis and coma. The child was diagnosed with acute herpetic gingivostomatitis one week before onset of neurological symptoms. MRI brain and angiography revealed extensive thrombosis of the straight, transverse and occipital venous sinuses, bilateral thalamic infarction and left haemorrhagic transformation with intraventricular hemorrhage and univentricular obstructive hydrocephalus. Thrombophilic screening was performed and a heterozygous mutations genes of C677T MTHFR and 4G/5G PAI was detected. He was treated with low molecular weight heparin (enoxaparine) followed by oral anticoagulant (acenocumarol) with good clinical outcome and complete neurological recovery. Conclusions: CSVT in children can be fully reversible with early diagnosis and a prompt management. Brain MRI with angio MRI remains the gold standard for diagnosing CSVT.Thrombofilic screening should be considered in any child with stroke history and CSVT. Herpes simplex virus associated infections may precipitate thrombosis in individuals with inherited or acquired hypercoagulable states. [ABSTRACT FROM AUTHOR]

In the period 2020-2022 as a result of epidemiological measures specific to the COVID-19 pandemic (protective mask, online teaching activity, social distancing) we witnessed a considerable decrease in the number of cases of respiratory viroids in children. With the lifting of prophylactic measures that coincided with the start of physical teaching activities and the onset of the cold season, we have been confronted in pediatric wards with an increase in the incidence of virological infections in the pediatric population. In this article we aim to analyze the particularities of respiratory virological diseases in children in the season 2022 - 2023 both from the etiological and epidemiological point of view and the characteristic clinical forms of the disease. We conducted a retrospective clinical study of cases admitted to the Clinical Departments of Infectious DiseasesPediatrics of the National Institute of Infectious Diseases “Prof. Dr. Matei Bals” in the period October 2022 - March 2023. During this period, we recorded 3.012 cases of respiratory virology in children, which represents the majority of pediatric pathology admitted (72,9 %). The peak incidence of respiratory virology occurred in December (688 cases). From the etiological point of view, most cases were SARS-CoV-2 infections, followed by influenza (predominantly type A), then a smaller number of infections with respiratory syncytial virus (RSV), rhinovirus, adenovirus, metapneumovirus. The most common clinical form of the disease was moderate (66.9%), with severe forms accounting for 10.5%. All pediatric cases of respiratory virology admitted to our wards have evolved favorably, with no deaths. [ABSTRACT FROM AUTHOR]

SARS-CoV-2 infection is usually a self-limiting viral infection in healthy children. Still, it’s effects on the neonatal population remain largely unknown. There has been evidence of adverse events on neonates, mostly consisting in case reports of patients with severe forms of COVID-19 and also recent cohort studied of the pediatric population including the neonatal subgroup. The clinical presentation appears different in the neonatal patients in contrast with older children, and may manifest also as a life-threatening respiratory infection with systemic complications. In this paper we present a clinical case of a premature boy with a corrected age of 40 weeks at admission to the Pediatric Infectious Diseases Clinical Department IX of the National Institute of Infectious Diseases “Prof. Dr. Matei Bals” with the diagnosis of SARS-CoV-2 infection. The positive diagnosis was established on suggestive clinical picture (fever, dry couch, rhinorrhea, loose stools and inappetence) and confirmed by SARS-CoV-2 rapid antigen test. Laboratory investigations at admission showed only moderate to severe anemia, mild inflammatory syndrome and a mild neonatal hyperbilirubinemia, with normal leukocyte count, normal glycaemia, ionograme and blood gases. Chest x-ray showed moderate interstitial pneumonia. In the second day of admission, after 24h of favorable evolution, with no fever and present appetite, he suddenly presented during defecation a presumptive vasovagal syndrome, with general hypotonia and a short period of desaturation. Laboratory investigations made during the episode showed normal glycaemia, normal ionograme, normal blood gases, moderate-severe anemia and important metabolic acidosis. A new chest x-ray showed evolution of the interstitial pneumonia. We did a blood transfusion and continued antiviral treatment, antibiotic treatment and perfusions. He maintained normal pulmonary and cardiac function for another 6 hours, after which he presented a tonic-clonic seizure and after administration of intrarectal benzodiazepines he presented cardio-pulmonary arrest. He was resuscitated, intubated and sedated and transfer to a children ICU. 2 weeks later after admission in the ICU he was discharged with favorable outcome. The case presented shows that although SARS-CoV-2 infection is often a mild condition in children, COVID-19 in neonates can have an unpredicted course. Rapid evolution to sever forms can be a possible disease outcome. Preterm birth with associated complications like bronchodysplasia or anemia, can predispose to sever evolution of the disease, and this child must be kept safe. There is also a neurotropic potential of the SARS-CoV-2 virus that has to be followed. [ABSTRACT FROM AUTHOR]