Response to "The importance of an early gastroenteritis diagnosis to discard MIS-C during SARS-CoV-2 pandemic".

Abstract

Rev Esp Quimioter 2023;36(3): 322-324 322 Results are shown in Table 1. As expected, more cases of Campylobacter infection were diagnosed in the first period while more laboratory studies were performed in the second period (47.2% vs 14.9%), probably as a reflection of the fear of missing a possible diagnosis of MIS-C in the pandemic era. No cases showing both elevated C-reactive protein and profound lymphopenia were observed among the 74 children seen in the prepandemic period, while four (11.1% of the total cases and 30.6% of those in whom laboratory tests were performed) were found in the pandemic era. Evidence of SARS-CoV-2 exposure in the previous weeks was confirmed in three of these cases and infection was documented in one child, who was initially diagnosed as possible MIS-C and treated with intravenous gammaglobulin and corticosteroids for one day; treatment was suspended when the diagnosis of Campylobacter infection was confirmed. Clinical characteristics and laboratory findings of these four patients are shown in table 2. Our results raise the question of whether Campylobacter infection alone can be accountable for these laboratory findings and if a positive stool test can safely rule out a diagnosis of MIS-C or a short observation period in the hospital would be prudent, as children with MIS-C may develop additional organ system involvement over the course of admission [4]. Lymphopenia has been previously described in up to 11% of patients with Campylobacter infection returning from the tropics, Response to “The importance of an early gastroenteritis diagnosis to discard MIS-C during SARS-CoV-2 pandemic”