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The pathophysiology of multisystem inflammatory syndrome in children (MIS-C) and associated oral symptoms have not been clarified yet. The aim of the present study was to compare the oral health status of children with MIS-C-associated Coronavirus disease 2019 (COVID-19) and COVID-19. A total of 54 children with SARS-CoV-2 infection, 23 with MIS-C-associated COVID-19 and 31 with asymptomatic, mild, and moderate COVID-19 were recruited for the present cross-sectional study. Sociodemographic variables, medical examinations, oral hygiene habits, and extraoral and intraoral findings (DMFT/dmft index, OHI scores, and oral mucosal changes) were recorded. The t-test for independent samples and the Mann-Whitney U test were used (p < 0.05). MIS-C was found to be associated with chapped lips (all patients) and oral mucosal changes, including erythema, white lesion, strawberry tongue, and swelling of the gingiva as compared to the COVID-19 group (frequency of more than one mucosal change: 100% vs. 35%) (p < 0.001). Children with MIS-C presented higher DMFT/dmft scores (DMFT/dmft 5.52 ± 3.16 for the MIS-C group vs. 2.26 ± 1.80 for the COVID-19 group) (p < 0.01). Elevated OHI scores were also associated with MIS-C (mean ± SD: 3.06 ± 1.02 (MIS-C) vs. 2.41 ± 0.97 (COVID-19) (p < 0.05). Oral manifestations, mainly strawberry and erythematous tongue, were characteristic features of MIS-C. Prevalence of oral/dental symptoms was elevated in children with MIS-C when compared to COVID-19. Therefore, dental professionals should be aware of the oral manifestations associated with MIS-C, which may have high mortality and morbidity rates.

İnvaziv Grup A Streptokok Tanılı Çocuk Olguların Klinik Seyir ve Sonuçlarının DeğerlendirilmesiPelin Laleoğlu, İrem Ceren Erbaş, Şilem Özden Alataş, Hatice Karaoğlu Asrak, Ayşe Çakıl Güzin, Nurşen BeletGirişGrup A streptokoklar (GAS), farenjit ve impetigo gibi invaziv olmayan hastalıklardan, nekrotizan fasiit, abse, bakteriyemi ve toksik şok sendromu gibi çok ciddi sonuçlara yol açabilecek çeşitli enfeksiyonlara ve komplikasyonlara neden olabilen gram pozitif bakterilerdir. Bu çalışmada merkezimizde izlediğimiz invaziv GAS enfeksiyonlarının özellikleri değerlendirilmiştir.Gereç ve YöntemOcak 2017- Ocak 2023 tarihleri arasında, 18 yaşından küçük invaziv GAS enfeksiyonu tanısıyla izlediğimiz olguların dosyaları incelenerek demografik özellikleri, klinik seyri, laboratuvar ve tedavi sonuçları retrospektif olarak değerlendirildi.BulgularAltı yıl boyunca, 3’ü kız (% 30) olmak üzere toplam 10 olgu invaziv GAS enfeksiyonu tanısıyla izlendi. Hastaların %60’ı son 3 ay içinde tanı aldı. Hastaların ortanca yaşı 84 (min-max; 37-169) aydı. En sık başvuru şikayeti ateş ve boğaz ağrısıydı. Olgulardan %40’ü (n=4) bakteriyemi, %30’u (n=3) komplike pnömoni, %10’u (n=1) derin boyun absesi, %10’u (n=1) komplike sinüzit, frontal abse ve %10’u (n=1) streptokoksik toksik şok sendromuydu. Başvuru sırasında hastaların ortanca WBC: 17,240/uL(1,600-27,200/uL), ANS: 14,560/uL(100-25,200/uL), PLT: 344,000/uL(89,000-766,000/uL), CRP: 213 mg/L(2-461mg/L), eritrosit sedimentasyon hızı: 46 mm/saat(19-101 mm/saat), prokalsitonin: 30 ng/ml(1-75ng/ml) idi. Olgulardan birinde (%10) karaciğer fonksiyon testlerinde bozukluk vardı. Hastaların %30’unun boğaz kültüründe, %50’sinin kan kültüründe, %30’unun apse kültüründe, %20’inin plevral sıvı kültüründe etken üretildi. Tedavide en sık 3. kuşak sefalosporinlerle birlikte klindamisin kullanıldı. Hastanede yatış süresi ortanca 28,3 (12- 56); toplam tedavi süresi ortanca 20 (8-56) gündü. Destek tedavisi olarak %30’una IVIG verildi. Olguların %30’u yoğun bakımda izlendi ve %30’una cerrahi girişim uygulandı. Ex olan hastamız olmadı.SonuçGAS bakteriyemisi veya invaziv enfeksiyon insidansı çocuklarda yılda 100.000’ de 1- 3 vakadır. Ancak son zamanlarda Avrupa’da invaziv GAS enfeksiyonlarında artış bildirilmektedir. DSÖ, COVID-19 pandemisi öncesi döneme kıyasla 10 yaş altındaki çocuklarda sıklığında bir artış olduğunu, ancak ölümlerde anlamlı bir artış olmadığını bildirmektedir. Bu çalışmamızda GAS’ ların hayatı tehdit eden ciddi enfeksiyonlara neden olabildiğini, ancak erken tanı ve uygun tedavi ile bu enfeksiyonlardan ölümün engellenebileceğini gösterdik.

Background/aim: It is still not known how an immunosuppressive state affects the response to coronavirus disease 2019 (COVID-19) in children and adolescents. The aim of this study was to evaluate clinical characteristics, outcomes, and follow-up results of COVID-19 in pediatric patients with a history of immunocompromise or malignancy, retrospectively. Materials and methods: Patients with a diagnosis of COVID-19 who were under 18 years of age and had a history of immunosuppressive chronic disease or under immunosuppressant treatment were included in the study. Patients were applied to our outpatient clinic or consulted to our department in a tertiary center during the first year of the pandemic. Results: We evaluated 18 patients with a median age of 15.0 (0.6???17.8) years. Twelve patients (66.6%) were tested because of a symptom and the most common symptom was fever (44.4%, n = 8). Ten of the symptomatic patients (55.5% of all cohort) had a mild disease, the remaining two patients (11.1%) with an end-stage malignancy had critical diseases. Twelve patients (66.7%) were managed on an outpatient basis and were followed up at home, while the remaining six (33.3%) required hospitalization. One patient, who had Ewing sarcoma, died during the follow-up in the intensive care unit, and others were recovered without any morbidities. Lymphocyte (LYM) counts were significantly lower, C-reactive protein (CRP), and ferritin levels were higher in the individuals that needed hospitalization (p = 0.039, 0.027, and 0.039, respectively). Conclusion: Immunocompromised children and adolescents with COVID-19 should be monitored closely, especially those with an end-stage malignancy, low LYM count, or high CRP and ferritin levels.

Objective: With the rapid spread of SARS-CoV-2, a new coronavirus, around the world, a pandemic was declared by World Health Organization on March 2020. The first cases were reported in March 2020 from Turkey. In our hospital, the first pediatric case was detected on April 2, 2020. However, there is no data on whether this virus had been present in our region or not before this date. The aim of our study was to determine the first entry of SARS-CoV-2 virus to our region for pediatric patients.