SARS-CoV-2 identification in an acute appendicitis case: Acute abdomen as manifestation of Multisystem Inflammatory Syndrome in a child with COVID-19

Abstract

Coronavirus disease 2019 (COVID-19) pandemic is a global health emergency. The clinical course of COVID-19 in children is mild in most of the cases, but multisystem inflammatory syndrome in children (MIS-C) is recognized as a potential life-threatening complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Acute abdomen as a presentation of COVID-19 is rare, and its correlation to COVID-19 features and prognosis remains undetermined. Herein, we describe a case of appendicitis in a child with confirmed diagnosis of COVID-19 and subsequent SARS-CoV-2 identification in appendix tissue.

Keywords: Appendicitis; COVID-19; MIS-C; pathology.

Fig. 1

Inflammatory infiltrate with neutrophils and mononuclear cells and hemorrhage (1A); extensive areas of wall necrosis with loss of mucosa - HE (10 X/20 × 4 X/0.10) (1B); positive detection of SARS-CoV-2 N antigen (in red) in the cytoplasm of appendix glands (1C) and cytoplasm of mononuclear cells in the lymphoid nodules (1D), by immunohistochemistry reaction.