Introduction: Novel coronavirus or coronavirus disease (COVID-19) can affect all age groups. The clinical course of the disease in children and infants is milder than in adults. It should be noted that, although typical symptoms may be present in children, non-specific symptoms could be noted in the neonate. The disease is rare in the neonate, so, its suspicion in this group can help to make a quick diagnose.

Background:Functional abdominal pain (FAP) is one of the most common diseases, and large percentages of children suffer from it.Objectives:The purpose of the study was to evaluate the effect of Lactobacillus reuteri in treatment of children with functional abdominal pain.Patients and Methods:This study was a randomized double-blind placebo-controlled trial. Children aged 4 to 16 years with chronic functional abdominal pain (based on Rome III criteria) were enrolled in the study. They were randomly divided into two groups, one receiving probiotic and the other placebo. Results:Forty children received probiotic and forty others placebo. There were no significant differences in age, weight, sex, location of pain, associated symptoms, frequency and intensity of pain between the groups. The severity and frequency of abdominal pain in the first month compared to baseline was significantly less and at the end of the second month, there was no significant difference between both groups compared to the end of the first month.Conclusions:This study showed that the severity of pain was significantly reduced in both groups. There was no significant difference in pain scores between them. The effect of probiotic and placebo can probably be attributed to psychological effect of the drugs.

The manifestations of novel coronavirus are diverse and can manifest through respiratory, gastrointestinal, and even nervous symptoms. Respiratory involvement is usually an upper tract infection or pneumonia but can also present as other forms of pulmonary disorders. A 3-year-old boy presented with cough, hoarseness, and stridor. He was treated with dexamethasone and nebulized adrenaline and a clinical diagnosis of croup was established. After treatment, his symptoms improved for a short time, but suddenly cough exacerbated and was accompanied by respiratory failure and seizures. He was then intubated and mechanically ventilated. Because of the coronavirus epidemic, Reverse-Transcription Polymerase Chain Reaction (RT-PCR) assay was taken from the pharyngeal secretions and was positive. The child was isolated. Due to excessive respiratory secretions and worsening of the general condition, bronchoscopy was performed depicting an image compatible with bacterial tracheitis. He was treated with broad-spectrum antibiotics, antivirals, and supportive care. Finally, after 4 weeks of treatment, the child was discharged in good general condition. Croup is one of the respiratory symptoms of novel coronavirus and can be a risk factor for bacterial tracheitis. Therefore, the presence of clinical manifestations of croup indicates the need for coronavirus PCR testing.

Today clinicians may diagnose hundreds of people with coronavirus disease 2019 (COVID-19). We report the case of a child with asthma who sought care for COVID-19 symptoms whose condition did not improve despite appropriate treatment for asthma, pneumonia and COVID-19. Further examination revealed a surprising underlying disease. It is important to consider that in pandemics such as COVID-19, because all attention is paid to the disease, underlying hidden causes may be neglected.

The main manifestations of novel coronavirus usually include fever and cough. Neurological manifestations have not been properly identified in children. A 65-day-old infant was hospitalized due to poor feeding, weakness, lethargy, and occasional cough. She suffered several seizures during her hospitalization. The brain computed tomography scan depicted a minor hemorrhage. Due to the exacerbation of her condition during hospital stay and the presence of respiratory symptoms in her parents, coronavirus disease was suspected. Reverse transcription–polymerase chain reaction (PCR) of coronavirus was positive for both: child and parents. In children with neurological manifestations such as lethargy, recurrent seizures, cerebral hemorrhage, and clinical evidence of respiratory symptoms in his/her relatives, PCR testing for coronavirus is recommended.

Toxic shock syndrome in children following infection with influenza is a very rare syndrome. If it is not diagnosed quickly, it may cause significant morbidity and mortality. For diagnosis of toxic shock syndrome, clinical and laboratory criteria are used. Our patient is a 3.5year old boy who admitted to the hospital with high fever, weakness, toxicity, hypotension and skin rash due to influenza-like Illness (fever, pharyngitis, rhinitis and non-productive cough) associated with gastrointestinal symptoms, elevated liver enzymes levels, low platelet count and mucosal hyperemia. After the treatment, he recovered and was discharged from the hospital in good condition, but had mild scaling on the soles of the feet and between toes. To our knowledge, this is the first reported case in a young child. There is not any specific diagnostic test for toxic shock syndrome diagnosis, and the diagnosis is based on clinical and laboratory findings. Therefore, the early detection and treatment of the condition is very important because delay in treatment leads to increased mortality and morbidity.

Introduction: Toxic Epidermal Necrolysis (TEN) is a severe disease with high mortality, which can occur following the administration of some drugs such as antibiotics, anticonvulsants and non-steroidal anti-inflammatory drugs (NSAIDs). The condition is rare in children; therefore, providing a therapeutic experience and methods of care can be very helpful in similar cases. Case Presentation: A 32-month-old girl (2.8 years) was admitted at Mousavi Hospital of Zanjan (Iran) presenting weakness, illness, scattered macular lesions on the trunk and extremities, and several blisters on the trunk. He had a history of upper respiratory tract infection and had been administered a diclofenac suppository for fever. All the clinical manifestations appeared after diclofenac administration. The lesions rapidly progressed to extensive cutaneous necrosis with the involvement of more than 70% of the body surface. He was treated with high-dose intravenous immunoglobulin (IVIG), corticosteroid, and conservative management. Fortunately, the child was discharged in good general condition approximately one month after the onset of the illness. Conclusions: Diclofenac can cause TEN in children, even in single doses and in suppositories. The most important prognostic factors include supportive therapy, contact isolation, hand hygiene, and administration of high dose IVIG for at least three days.

No abstract