Objective: To evaluate the differential characteristics of SARS-COV-2 associated inflammatory multisystem syndrome (MIS-C) in children. Methods: A retrospective cohort study was conducted. The definition of MIS-C was based on WHO criteria. Temporally related COVID-19 patients were included as controls. Results: 25 patients with MIS-C and 75 controls were included. Multivariate multiple logistic regression model of variables that showed to be significant in univariate analysis revealed that age ≥2 years (OR 24.7; 95% CI 1.03 -592.4; P=0.048), lymphopenia (OR 9.03, 95%CI 2.05-39.7; P=0.004), and platelet count <150x10 9 / L (OR 11.7; 95% CI 1.88-75.22; P=0.009) were significantly associated with MIS-C. Presence of underlying disease seemed to reduce the risk of MIS-C (OR 0.06; 95% CI 0.01-0.3). Conclusion: MIS-C was more common in patients older than 2 years and in those with lymphopenia or thrombocytopenia. Underlying disease appears to reduce the risk of MIS-C.

Sin conflictos de interés. Este estudio no recibió financiamiento.

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The objective was to describe the epidemiological, clinical, microbiological, and evolutionary characteristics and the risk factors for mortality. Retrospective, cohort study. A total of 100 patients were included. Of these, 42 (42 %) had septic shock upon admission and 56 (56 %) were admitted to the intensive care unit. Bacteremia was primary in 17 patients (17 %); catheter-related, in 15 (15 %); and secondary, in 68 (68 %). The most common source of infection was the skin and mucous membrane. Resistance to one or more antibiotic groups was 38 %. Thirtyone patients died (31 %). Risk factors for mortality were septic shock (p < 0.0005), admission to the intensive care unit (p < 0.0001), primary bacteremia (p < 0.009) or secondary, non-catheter-related bacteremia (p < 0.003), presence of mucocutaneous or pulmonary source of infection (p < 0.004), and multidrug resistance (p < 0.01) or resistance to carbapenems (p < 0.01).

An 8-month-old child was admitted to a paediatric intensive care unit in Guinea-Bissau with severe blistering dermatosis. He was treated with broad spectrum antibiotics and dressings, without improvement. After 2 weeks, linear IgA bullous dermatosis was suspected. Owing to lack of dapsone, the child was treated with prednisolone and improved. To avoid corticosteroids side effects, 2 months after starting prednisolone we switched to colchicine, but the boy’s condition worsened for reasons of poor adherence, requiring intravenous corticosteroids and antibiotics. After complete resolution of the skin lesions, we continued with colchicine monotherapy, then changed to dapsone after 3 months. The child did not show any further signs of dermatosis, but his follow-up ended abruptly, because he did not return to the hospital. IgA bullous dermatosis is a challenging diagnosis in settings where pathological studies cannot be conducted. Multidisciplinary treatment is required and colchicine is a good option if dapsone is not available.