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Case Report: One Case of Coronavirus Disease 2019 (COVID-19) in Child with Thrombocytopenia and Skin Lesion

Received: 5 June 2020    Accepted: 29 June 2020    Published: 4 August 2020
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Abstract

COVID-19 disease characterized by a wide range of clinical manifestations of respiratory and gastrointestinal symptoms, like diarrhea and vomiting, in children and adults; also, some laboratory findings like thrombocytopenia and lymphopenia are reported in some cases, but Skin lesions are uncommon symptoms. In this study, we report a 7-year-old girl admitted to an emergency department of Besat hospital in Sanandaj, Iran, with erythematous maculopapular skin lesions manifestation. Our patients had other symptoms including fever, gastrointestinal symptoms (vomiting, loss of appetite, and diarrhea) severe systemic symptoms include respiratory distress and cardiomyopathy, and also she had abnormal laboratory findings like thrombocytopenia, leukocytosis, and lymphopenia. First of some differential diagnosis like gastrointestinal infection and Kawasaki disease was consider and but after rule outing these disease, COVID-19 infection was diagnosed for the patient by PCR testing of the nasopharyngeal sample. She treated with chloroquine and Kaletra for five days and Meropenem and Clindamycin. So we introduce thrombocytopenia and skin lesion as the clinical manifestation of COVID-19 disease in children. Also, according to this study, we recommend doing diagnostic tests to rule out COVID-19 disease in children with skin manifestation or thrombocytopenia. Also, it is necessary to understand the clinical features of COVID-19 in children.

Published in American Journal of Pediatrics (Volume 6, Issue 3)
DOI 10.11648/j.ajp.20200603.31
Page(s) 300-302
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

COVID-19 Disease, Thrombocytopenia, Skin Lesion

References
[1] Cascella M, Rajnik M, Cuomo A, et al. Features, Evaluation and Treatment Coronavirus (COVID-19) [Updated 2020 April 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554776/.
[2] Zhu N, Zhang D, Wang W et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020 January 24 (Epub ahead of print), DOI: 10.1056/NEJMoa2001017.
[3] Zimmermann, Petra, and Nigel Curtis. "Coronavirus Infections in Children Including COVID-19: An Overview of the Epidemiology, Clinical Features, Diagnosis, Treatment, and Prevention Options in Children." The Pediatric infectious disease journal vol. 39, 5 (2020): 355-368. DOI: 10.1097/INF.0000000000002660.
[4] Liguoro, I., Pilotto, C., Bonanni, M. et al. SARS-COV-2 infection in children and newborns: a systematic review. Eur J Pediatr (2020). https://doi.org/10.1007/s00431-020-03684-7.
[5] CDC COVID-19 Response Team. "Coronavirus Disease 2019 in Children - United States, February 12-April 2, 2020." MMWR. Morbidity and mortality weekly report vol. 69, 14 422-426. April 10. 2020, DOI: 10.15585/mmwr.mm6914e4.
[6] Xu, Panyang, et al. "Mechanism of thrombocytopenia in COVID-19 patients." Annals of hematology, 1–4. 15 Apr. 2020, DOI: 10.1007/s00277-020-04019-0.
[7] Magdi, Mohamed, and Ali Rahil. "Severe Immune Thrombocytopenia Complicated by Intracerebral Haemorrhage Associated with Coronavirus Infection: A Case Report and Literature Review." European journal of case reports in internal medicine vol. 6, 7 001155. July 12, 2019, DOI: 10.12890/2019_001155.
[8] Lippi, Giuseppe et al. "Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: A meta-analysis." Clinica Chimica Acta; international journal of clinical chemistry, vol. 506 145-148. March 13. 2020, DOI: 10.1016/j.cca.2020.03.022.
[9] Joob, Buy, and Viroj Wiwanitkit. "COVID-19 can present with a rash and be mistaken for dengue." Journal of the American Academy of Dermatology vol. 82, 5 (2020): e177. DOI: 10.1016/j.jaad.2020.03.036.
[10] Sachdeva, Muskaan et al. "Cutaneous manifestations of COVID-19: Report of three cases and a review of the literature." Journal of dermatological science, S0923-1811 (20) 30149-3. April 29. 2020, DOI: 10.1016/j.jdermsci.2020.04.011.
[11] Genovese G, Colonna C, Marzano AV. Varicella-like exanthem associated with COVID-19 in an 8-year-old girl: A diagnostic clue? Pediatric Dermatology. 2020.
Cite This Article
  • APA Style

    Masoumeh Abedini, Borhan Moradveisi, Mohammad Ghaderi, Avat Karimi, Farima Zakaryaei. (2020). Case Report: One Case of Coronavirus Disease 2019 (COVID-19) in Child with Thrombocytopenia and Skin Lesion. American Journal of Pediatrics, 6(3), 300-302. https://doi.org/10.11648/j.ajp.20200603.31

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    ACS Style

    Masoumeh Abedini; Borhan Moradveisi; Mohammad Ghaderi; Avat Karimi; Farima Zakaryaei. Case Report: One Case of Coronavirus Disease 2019 (COVID-19) in Child with Thrombocytopenia and Skin Lesion. Am. J. Pediatr. 2020, 6(3), 300-302. doi: 10.11648/j.ajp.20200603.31

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    AMA Style

    Masoumeh Abedini, Borhan Moradveisi, Mohammad Ghaderi, Avat Karimi, Farima Zakaryaei. Case Report: One Case of Coronavirus Disease 2019 (COVID-19) in Child with Thrombocytopenia and Skin Lesion. Am J Pediatr. 2020;6(3):300-302. doi: 10.11648/j.ajp.20200603.31

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  • @article{10.11648/j.ajp.20200603.31,
      author = {Masoumeh Abedini and Borhan Moradveisi and Mohammad Ghaderi and Avat Karimi and Farima Zakaryaei},
      title = {Case Report: One Case of Coronavirus Disease 2019 (COVID-19) in Child with Thrombocytopenia and Skin Lesion},
      journal = {American Journal of Pediatrics},
      volume = {6},
      number = {3},
      pages = {300-302},
      doi = {10.11648/j.ajp.20200603.31},
      url = {https://doi.org/10.11648/j.ajp.20200603.31},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20200603.31},
      abstract = {COVID-19 disease characterized by a wide range of clinical manifestations of respiratory and gastrointestinal symptoms, like diarrhea and vomiting, in children and adults; also, some laboratory findings like thrombocytopenia and lymphopenia are reported in some cases, but Skin lesions are uncommon symptoms. In this study, we report a 7-year-old girl admitted to an emergency department of Besat hospital in Sanandaj, Iran, with erythematous maculopapular skin lesions manifestation. Our patients had other symptoms including fever, gastrointestinal symptoms (vomiting, loss of appetite, and diarrhea) severe systemic symptoms include respiratory distress and cardiomyopathy, and also she had abnormal laboratory findings like thrombocytopenia, leukocytosis, and lymphopenia. First of some differential diagnosis like gastrointestinal infection and Kawasaki disease was consider and but after rule outing these disease, COVID-19 infection was diagnosed for the patient by PCR testing of the nasopharyngeal sample. She treated with chloroquine and Kaletra for five days and Meropenem and Clindamycin. So we introduce thrombocytopenia and skin lesion as the clinical manifestation of COVID-19 disease in children. Also, according to this study, we recommend doing diagnostic tests to rule out COVID-19 disease in children with skin manifestation or thrombocytopenia. Also, it is necessary to understand the clinical features of COVID-19 in children.},
     year = {2020}
    }
    

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    T1  - Case Report: One Case of Coronavirus Disease 2019 (COVID-19) in Child with Thrombocytopenia and Skin Lesion
    AU  - Masoumeh Abedini
    AU  - Borhan Moradveisi
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    AB  - COVID-19 disease characterized by a wide range of clinical manifestations of respiratory and gastrointestinal symptoms, like diarrhea and vomiting, in children and adults; also, some laboratory findings like thrombocytopenia and lymphopenia are reported in some cases, but Skin lesions are uncommon symptoms. In this study, we report a 7-year-old girl admitted to an emergency department of Besat hospital in Sanandaj, Iran, with erythematous maculopapular skin lesions manifestation. Our patients had other symptoms including fever, gastrointestinal symptoms (vomiting, loss of appetite, and diarrhea) severe systemic symptoms include respiratory distress and cardiomyopathy, and also she had abnormal laboratory findings like thrombocytopenia, leukocytosis, and lymphopenia. First of some differential diagnosis like gastrointestinal infection and Kawasaki disease was consider and but after rule outing these disease, COVID-19 infection was diagnosed for the patient by PCR testing of the nasopharyngeal sample. She treated with chloroquine and Kaletra for five days and Meropenem and Clindamycin. So we introduce thrombocytopenia and skin lesion as the clinical manifestation of COVID-19 disease in children. Also, according to this study, we recommend doing diagnostic tests to rule out COVID-19 disease in children with skin manifestation or thrombocytopenia. Also, it is necessary to understand the clinical features of COVID-19 in children.
    VL  - 6
    IS  - 3
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Author Information
  • Department of Infectious Diseases, Kurdistan University of Medical Sciences, Sanandaj, Iran

  • Cancer and Immunology Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran

  • Department of Pediatrics, Kurdistan University of Medical Sciences, Sanandaj, Iran

  • Department of Pediatrics, Kurdistan University of Medical Sciences, Sanandaj, Iran

  • Emergency Department, Kurdistan University of Medical Sciences, Sanandaj, Iran

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