Microvascular injury in the appendix of a pediatric patient with history of COVID-19 infection: A case report

Ashok Kumar Malik,Maryam Fadhel Hammad

doi:10.5348/100101z06mh2021cr

Abstract

Introduction: A novel coronavirus (SARS-CoV-2) infection has emerged in the world causing a pandemic disease with severe forms of acute respiratory failure along with other organs manifestations. Besides, frequent association with multisystem inflammatory syndrome in children (MIS-C) as complication after the recovery has been recorded. Hereby we report the histological findings in the appendix of a female pediatric patient with history of COVID-19 infection. Case Report: In our case, an 8-year-old female patient presented to the emergency department of our main tertiary hospital in Bahrain with two days history of low grade fever, lower abdominal pain, nausea, and vomiting. She was admitted to the pediatric surgical unit for a suspected acute appendicitis. A diagnostic laparoscopy and laparoscopic appendectomy was performed. The appendix was sent to the histopathology examination which confirmed the diagnosis of acute suppurative appendicitis with focal endarteritis obliterans. Retrospectively history revealed the child was COVID-19 positive three months back. Conclusion: Microvascular injury in the appendix of our case adds to the preliminary available evidences in the literature indicating that endarteritis obliterans of the gastrointestinal (GI) tract organs could be a complication of the COVID-19 virus infection like in MIS-C which is a known post-infectious complication of the virus.

Highlights

A novel coronavirus (SARS-CoV-2) infection has emerged in the world causing a pandemic disease with severe forms of acute respiratory failure along with other organs manifestations
Microvascular injury in the appendix of our case adds to the preliminary available evidences in the literature indicating that endarteritis obliterans of the gastrointestinal (GI) tract organs could be a complication of the COVID-19 virus infection like in multisystem inflammatory syndrome in children (MIS-C) which is a known post-infectious complication of the virus
In early January2020, the Chinese Center for Disease Control announced the case of the reported cases with these symptoms and it was the identification of a novel coronavirus (SARS-CoV-2) [1], after that, in March 11, World Health Organization declared it as a new pandemic disease (COVID-19) [1]

Summary

Conclusion

Microvascular injury in the appendix of our case adds to the preliminary available evidences in the literature indicating that endarteritis obliterans of the gastrointestinal (GI) tract organs could be a complication of the COVID-19 virus infection like in MIS-C which is a known post-infectious complication of the virus. Affiliations: 1Senior Histopathology resident, Pathology Department, Salmaniya Medical Complex, Manama, Kingdom of Bahrain; 2Senior Histopathology consultant, Pathology Department, Salmaniya Medical Complex, Manama, Kingdom of Bahrain. Microvascular injury in the appendix of a pediatric patient with history of COVID-19 infection: A case report.

INTRODUCTION

Findings

DISCUSSION

CONCLUSION