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Fever with Rash is One of the First Presentations of COVID-19 in Children: A Case Report

Authors Navaeifar MR, Poudineh Ghazaghi M, Shahbaznejad L, Rouhanizadeh H, Abutalebi M, Ranjbar Varandi M, Rezai MS

Received 15 May 2020

Accepted for publication 10 July 2020

Published 7 August 2020 Volume 2020:13 Pages 335—340


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Professor Ronald Prineas

Mohammad Reza Navaeifar,1 Mehrdad Poudineh Ghazaghi,2 Leila Shahbaznejad,1 Hamed Rouhanizadeh,3 Mahnush Abutalebi,2 Mobina Ranjbar Varandi,2 Mohammad Sadegh Rezai1

1Pediatric Infectious Diseases Research Center, Mazandaran University of Medical Sciences, Sari, Iran; 2Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran; 3Pediatric Department, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran

Correspondence: Mohammad Sadegh Rezai
Bu-Ali Sina Hospital, Mazandaran University of Medical Sciences, Sari, Iran

Introduction: Clinical presentations of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vary among patients, which make a confusing challenge for clinicians to diagnose the disease. While the disease is not rare, but the symptoms may be atypical in children.
Case Presentation: A 12-month-old boy with fever and rash without respiratory complaints at the onset of the disease presented to the hospital. His illness was then accompanied by severe anemia, hypoalbuminemia, hypoxemia, and pleural effusion. The nasopharyngeal swab polymerase chain reaction test was positive for the novel coronavirus. Despite primary normal lung imaging, the second imaging was typical for the disease on the third day of admission.
Discussion: Dermatologic manifestations of the novel coronavirus infection are not rare during the illness but rarely occur at the onset of the disease. Information about the cutaneous manifestations of SARS-CoV-2 and its time interval from the onset of the disease in children are not clear yet. Severe anemia, hypoalbuminemia, and pleural effusion are not reported as classic findings of the novel SARS-CoV-2. They may be considered as a consequence of the hyperinflammatory response or direct effect of the virus.
Conclusion: As a different manifestation of SARS-CoV-2, infected children may initially present fever and rash. More studies are needed to discover the cause of these complications. The correct answer may lead to better insight and more effective treatment.

Keywords: SARS-CoV-2, COVID-19, fever, rash, children

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