Post-covid syndrome in children

Multisystem inflammatory syndrome in children associated with COVID-19 is a new disease, information first appeared in April 2020. There were reported cases of hospitalized children with unusual symptoms, manifested primarily by fever and multisystem inflammation from the pediatricians in the UK and other countries during the coronavirus infection pandemic (COVID-19). Some of these children were in critical condition with symptoms of shock and multiple organ failure, and some children had manifestations similar to Kawasaki disease. Despite the fact that COVID-19 in children is relatively easy, some of the «convalescents» after 2–6 weeks develop symptoms largely identical to the manifestations of severe forms of new coronavirus infection in adults. The report presents own clinical cases of multisystem inflammatory syndrome that developed in children after acute form of a new coronavirus infection. The authors discuss the possible clinical variants of the syndrome, its origin and outcomes.

Urethral Carcinoma in Patients with Urethral Stricture: A Case Report

Primary cancer of the urethra is rare. Its clinical presentation is nonspecific and urethral stricture is one of its risk factors. Authors report herein the case of a 65-year-old male patient with a history of recurrent urethral stricture for which he opted for a suprapubic catheter. He developed a perineal phlegmon that revealed a primary urethral carcinoma. This case shows unusual symptoms that should lead to suspect urethral carcinoma in a patient with urethral stricture. This will allow to avoid late diagnosis caused by misleading symptoms.

Giant cell arteritis characterised by sore throat

Giant cell arteritis is a devastating condition that can lead to permanent vision loss. Early diagnosis is vital to initiate corticosteroid treatment before irreversible visual symptoms develop. This case study examines an 81-year-old woman with a history of polymyalgia rheumatica who initially presented with sore throat and headache. She was ultimately diagnosed with giant cell arteritis. However, her diagnosis was delayed by multiple emergency and outpatient providers who failed to evaluate her for giant cell arteritis. Her story reflects the importance of assessing polymyalgia rheumatica patients for giant cell arteritis even when presenting with more unusual symptoms, such as sore throat.

Interleukin-6 producing pheochromocytoma/paraganglioma: case series from a tertiary referral centre for pheochromocytomas and paragangliomas

Introduction In addition to catecholamines, pheochromocytomas and paragangliomas (PPGL) may secrete interleukin-6 (IL-6). IL-6 contributes to the development of unusual symptoms, which may hinder the diagnosis. Patients and methods We report the clinical course and subsequent treatment of IL-6 producing PPGL in three patients from a single tertiary referral centre for PPGL patients in the Netherlands. Conclusion PPGL combined with persistent elevated inflammatory markers, either in the presence or absence of pyrexia, raised suspicion of IL-6 overproduction in these three patients. Although surgical resection of the tumour is the only curative treatment option, our case series adds to the accumulating evidence that alpha-blockers might be effective in these patients.

Chikungunya associated vulvitis: case report and literature review

Introduction: Chikungunya virus is spreading worldwide due to migration and globalization and could be presented with systemic and with unusual symptoms. Objective: To report a case of virus-transmitted infection detected in a woman during the gynecological examination at a vulvar clinic. Case report: A 73-year-old Caucasian woman attended a vulvar clinic because of dyspareunia and vulvar burning. Ulcers were observed on labia minora and perineum. A Chikungunya was diagnosed by seroconversion in paired specimens. She was prescribed prednisolone 40 mg once a day for 10 days. After oral steroid treatment, the woman had no body rashes or lesions on her genitals. Conclusion: This study emphasized that rare signs of unusual vulvitis with ulcers could be associated with Chikungunya infection.

Pathogens carried by Ixodes ricinus and Dermacentor reticulatus ticks including coinfections

Ticks and tick-borne pathogens are becoming an emerging threat to the health of both humans and animals. The number of cases of tick-borne diseases, especially Lyme disease, is constantly growing. Over the last several years, coinfections, which could be explained as presence of two of more pathogens in one organism are being observed with growing interest. Their occurrence may lead to severe or unusual symptoms, prolonged disease duration, diagnostic and therapeutic difficulties. Research on this subject concerns mainly ticks of the species Ixodes ricinus, however, literature data suggest that also the species Dermacentor reticulatus plays an important role as a vector of tick-borne pathogens.