The parents' and nurses' attitudes demonstrated fear of fever and its consequences. The approach to paediatric fever was significantly different among healthcare professionals.

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Outcomes of Covid-19 organizing pneumonia in critically ill patients Dear editor,Efficacy of corticosteroids in COVID-19 pneumonia has been reported in numerous studies. 1 However, Yang et al. concluded that corticosteroids have a negative impact, suggesting that not all patients benefit from the therapy. 2 Features of organizing pneumonia (OP) have been observed in radiological and histopathological studies from these patients. [3][4][5] OP has usually a good response to corticosteroids. The possible correlation between the radiological pattern and clinical evolution has important implications. This study provides information on patient selection and clinical application of corticosteroids. Fig. 1. Patient allocation according to chest CT scan findings. ARF: acute hypoxic respiratory failure; NIRS: noninvasive respiratory support; CT: computed tomography; GGO: ground glass opacities; OP: organizing pneumonia; DI: "do intubate"order; DNI: "do not intubate" order; ETI: endotracheal intubation.Adult patients admitted to a respiratory intermediate care unit (RICU) from November 18th, 2020 to February 18th, 2021 were prospectively enrolled. Institutional review boards authorised the study. Informed consent was waived.A confirmed case of COVID-19 pneumonia was defined as a patient with compatible symptoms and PCR-confirmed infection. Only patients needing advanced noninvasive respiratory support (NIRS) with high flow nasal cannula (HFNC), continuous positive airway pressure (CPAP) and/or noninvasive ventilation (NIV) were included. All patients had a "do intubate" (DI) or "do not intubate" (DNI) order defined at admission. Information regarding demographics, comorbidities, blood test results and mode and usage of NIRS were recorded. The severity of respiratory failure was assessed by PaO2/FiO2 ratio before NIRS institution. Several out-

Rhabdomyolysis is a pathological condition presenting with symptoms of localized or generalized myalgia and weakness, associated with an increase in serum creatine kinase level and, often leading to myoglobinuria and acute kidney injury. It has a wide range of etiologies. Immune-mediated necrotizing myopathy (IMNM) is a rare type of inflammatory myopathy, that leads to rhabdomyolysis, and it is divided into three different subtypes: anti-3-hydroxy-3-methylglutaryl-coA reductase (anti-HMGCR, anti-signal recognition particle (anti-SRP), and seronegative. There are slight differences in incidence, age of onset, clinical course, and prognosis between these subtypes.We describe the case of a 67-year-old female with myalgias and weakness of the thighs for six weeks. Laboratory findings showed marked rhabdomyolysis and severe acute kidney injury. The workup led to the diagnosis of seronegative immune-mediated necrotizing myopathy (IMNM) and treatment with corticosteroid and methotrexate was introduced, which led to marked clinical improvement.