An eight-year-old boy from East Tambaram presented with unusual symptoms for COVID-19 infection at the Kanchi Kamakoti CHILDS Trust Hospital.
On April 21, the boy developed fever. His parents managed him at home with paracetamol. But two days later the fever continued to rise and he complained of breathing difficulty. He refused food as he could not swallow. The parents took to him to a nearby hospital. The doctors conducted investigations and told them that it was a kind of pneumonia. There was phlegm in his chest. A test for COVID-19 was also done. But the results returned negative for the infection.
The hospital began treating the boy for fever. “He would have no fever during the day. But at nights the fever returned. He started developing rashes and pain in the abdomen a couple of days later. Doctors referred him to KKCTH,” the father, who did not want to reveal his identity, said. The boy was admitted to the hospital on April 26.
Bala Ramachandran, head of the paediatric intensive care unit at the hospital, said since the boy presented with low BP along with breathing difficulty, high fever, rashes and redness in the eye. He was admitted to the intensive care unit and was given non-invasive ventilation. Doctors suspected Kawasaki Disease, as he presented with symptoms of hyper inflammatory shock.
“After (administration of) immunoglobulin he continued to have the same symptoms. So we gave him Tocilizumab and after that he became much better. He was in the PICU for three days.”
Dr. Bala said of late reports of children with COVID-19 presenting with such atypical symptoms for the disease had started emerging in the United States and Europe.
“What is different is children do not always present like adults. They are known to present with fever, may or many not have respiratory symptoms. COVID-19 is a respiratory disease but world over we see children coming with diarrhoea and abdominal pain. Normally we don’t think of COVID-19. They come with rash, redness of the eye and strawberry tongue – these are inflammatory conditions. Paediatricians should be aware of this so that the infection in children are picked up early. It has to be treated differently,” he added.
Senior consultant S. Balasubramanian said the test for COVID-19 was repeated at the hospital as he presented with fever and pneumonia. The boy was discharged on Friday. Other members of the family would now have to undergo tests to rule out COVID-19, he added.
The doctors say when a child presents with unusual symptoms such as diarrhoea and abdominal pain or hyperinflammatory syndrome paediatricians should think of COVID-19 infection too.
