Carcinoma tímico en niños. Informe de dos casosThymic carcinoma in pediatric population: report of two cases RESUMEN El carcinoma tímico es una neoplasia poco frecuente en la población pediátrica. El diagnóstico diferencial se realiza con tumores mediastinales. Generalmente las manifestaciones clínicas se deben a obstrucción de la vía aérea. El tratamiento incluye cirugía, quimioterapia y radioterapia. Los esquemas de tratamiento, especialmente la quimioterapia, es motivo de controversia en niños y la mayoría de los protocolos se basan en la experiencia obtenida de los adultos. El pronóstico es malo, con pocas posibilidades de curación, depende del estadio según la clasificación de Masaoka y de la posibilidad de resección quirúrgica.En este informe se describen dos casos de carcinoma tímico en niños: uno de 12 años cuya afección se inició con cianosis e hipercalcemia y en una paciente de 14 años en quien empezó con tos y dolor torácico. ABSTRACTThymic carcinoma is a rare tumor in pediatric population. Differential diagnoses include mediastinal tumors. Most clinical manifestations are due to obstruction. Treatment includes surgery, chemotherapy and radiotherapy. The treatment schemes, especially chemotherapy, are controversial in children, and most of them are based on the experience with adult patients. In general, thymic carcinoma has a poor prognosis, with low chances for cure, and it is based on Masaoka et al classification and the possibility of surgical resection.We report two cases of thymic carcinoma in children: a 12-year-old boy who presented with cyanosis and hypercalcemia, and a 14-year-old girl whose inicial symptoms were cough and chest pain.

Background Worldwide SARS-CoV-2 infections increase every day. Despite the infection is less severe in children, it can be severe and associated with complications. However, local data remain scarce. We sought to describe epidemiological and clinical characteristics of COVID-19 infection in this population across different age groups. Methods Observational, multicenter study across 23 Colombian hospitals from 22 different territories. We included all patients from 0 months to 17 years with confirmed SARS-CoV-2 infection by either antigen or RT-PCR testing. Results From March 1, 2020, to October 31, 2021, we identified 1,186 patients: neonates (88), 1 to 3 months (130), 4 to 23 months (306), 2 to 4 years (169), 5 to 11 years (229) and 12 to 18 years (226) with confirmed COVID-19 infection. Of those,77(6.2%) were asymptomatic, 631(53.2%) hospitalized, 132(11.2%) required PICU. 58 cases met WHO definition of MIS-C. Patients less than 24 months of age were characterized by fever (74%) and more respiratory distress (30.1%) compared to other groups. Patients >5yo seemed to have a more severe presentation. They had more gastrointestinal (GI) symptoms (31% vs 37.8%), had more need for ICU care given presentation with shock increased with age ( >5yo 9.5%; 5-12yo 10.6%; 12-18yo 11.5%). Lab markers including thrombocytopenia and Lymphopenia were more common on this age group. Antibiotic treatment was common (%%) especially in neonates (40.9%), despite bacterial coinfection was rare (8.7%), length of hospitalization was longer in older than 2-year-old groups. 23(1.9%) patients died, similar across different age groups. Heat map by age group Conclusion COVID-19 infection in Colombian children presented differently across different age groups. Children older than 5 years had a more severe clinical course and prolonged hospital stays. Clinical findings according to age groups could help clinicians in characterizing and identifying COVID 19 infections in Children. Disclosures Ivan Felipe Gutiérrez Tobar, n/a, Pfizer and MSD (Advisor or Review Panel member, Research Grant or Support, Speaker’s Bureau, Has received support from Pfizer and MSD for participation in congresses and has received conference payments from Pfizer)Pfizer and MSD (Speaker’s Bureau, Other Financial or Material Support, Has received support from Pfizer for participation in congresses) Juan P. Rojas -Hernandez, Candidate for doctorate in Public Health, Pfizer (Other Financial or Material Support, Has received support from Pfizer for participation in congresses) Eduardo López Medina, n/a, Pfizer (Other Financial or Material Support, Has received support from Pfizer for participation in congresses)

Introducción: La endocarditis fúngica es una enfermedad infecciosa agresiva e infrecuente, considerada una emergencia en los servicios hospitalarios. Se ha evidenciado una incidencia de 0-12% del total de las admisiones pediátricas por endocarditis infecciosa. La mortalidad por Candida spp se encuentra alrededor del 50-80% en todos los casos. La Candida lusitaniae afecta principalmente a pacientes inmunocomprometidos, con uso de dispositivos intravasculares y el empleo de antibióticos de amplio espectro. Reporte de caso: Se presenta el caso de un lactante menor quien es diagnosticado con fungemia y endocarditis infecciosa por Candida lusitaniae en válvula nativa posterior a cirugía de corrección por transposición de grandes vasos. Discusión y Conclusiones: La endocarditis infecciosa por Candida lusitaniae es una entidad poco frecuente, con una prevalencia menor al 2% constituyéndose un escenario desafiante en la práctica clínica. Se describen las características de un lactante menor quien presentó endocarditis fúngica ya definidas en la literatura mundial. Es imprescindible la detección temprana y una intervención terapéutica vertiginosa; puesto que, la persistencia del inoculo, la resistencia antimicótica y el retraso en el diagnóstico conllevan a una condición amenazante para la vida del paciente.