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Background: SARS-CoV-2 infection can lead to multisystem inflammatory syndrome in children (MIS-C). We sought to investigate risk factors for admission to the intensive care unit (ICU) and explored changes in disease severity over time.Methods: We obtained data from chart reviews of children younger than 18 years with confirmed or probable MIS-C who were admitted to 15 hospitals in Canada, Iran and Costa Rica between Mar. 1, 2020, and Mar. 7, 2021. Using multivariable analyses, we evaluated whether admission date and other characteristics were associated with ICU admission or cardiac involvement.Results: Of 232 children with MIS-C (median age 5.8 yr), 130 (56.0%) were male and 50 (21.6%) had comorbidities. Seventy-three (31.5%) patients were admitted to the ICU but none died. We observed an increased risk of ICU admission among children aged 13-17 years (adjusted risk difference 27.7%, 95% confidence interval [CI] 8.3% to 47.2%), those aged 6-12 years (adjusted risk difference 25.2%, 95% CI 13.6% to 36.9%) or those with initial ferritin levels greater than 500 μg/L (adjusted risk difference 18.4%, 95% CI 5.6% to 31.3%). Children admitted to hospital after Oct. 31, 2020, had numerically higher rates of ICU admission (adjusted risk difference 12.3%, 95% CI -0.3% to 25.0%) and significantly higher rates of cardiac involvement (adjusted risk difference 30.9%, 95% CI 17.3% to 44.4%). At Canadian sites, the risk of ICU admission was significantly higher for children admitted to hospital between December 2020 and March 2021 than those admitted between March and May 2020 (adjusted risk difference 25.3%, 95% CI 6.5% to 44.0%).Interpretation: We observed that age and higher ferritin levels were associated with more severe MIS-C. We observed greater severity of MIS-C later in the study period. Whether emerging SARS-CoV-2 variants pose different risks of severe MIS-C needs to be determined. [ABSTRACT FROM AUTHOR]

Neonates born to women with confirmed or suspected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection should have testing of the nasopharynx, placenta and cord blood as soon as possible after birth, after thorough cleaning of the neonate. All 3 of the neonate's nasopharyngeal swabs were positive for SARS-CoV-2 gene targets via RT-PCR testing; neonatal plasma tested positive on day 4, and stool was positive on day 7. Debate regarding transmission via blood or during the birth process is common.[5] Thorough immediate testing is needed to understand the route of transmission of SARS-CoV-2 infection. [Extracted from the article]

The article discusses the prevalence of tuberculosis (TB) in children and adolescents in Canada. It examines the delayed diagnosis of pediatric tuberculosis (TB) due to the lack of diagnostic suspicion wherein TB may mimic many conditions. It also cites the role of physicians with experience in pediatric TB to achieve treatment in the disease.

The article discusses how to control the prevalence of the antibiotic-resistant bacteria in the ambulatory care settings in the U.S. The emergence of the vancomycin-resistant Enterococcus and Clostridium difficile and the transmission of the methicillin resistant staphylococcus aureus (MRSA) in the office and clinic is very rare. However, a routine infection-control measures are still needed, as well as an ongoing surveillance which will identify the epidemiology of the colonization and infection. The use of antimicrobials and hand hygiene are best ways to prevent and control the bacteria.

Presents a case study of a child who developed abscess in his psoas muscle. Medical history of the patient; Clinical manifestations of psoas abscess; Information on abscesses of the psoas.