{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T11:43:08Z","timestamp":1756381388341,"version":"3.44.0"},"reference-count":10,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,6,10]]},"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:p>COVID-19 infection in children is relatively mild and is associated with fewer complications compared with adults. Here we report the case of a previously healthy preteen girl who presented with active COVID-19 and shock. On day 1, ultrasound of the thorax revealed a right-sided pleural effusion with haemorrhagic pus on diagnostic tap, which improved clinically with appropriate hospital treatment. Even at discharge, the chest X-ray barely changed, indicating a fibrotic area and a collapsed lung. The patient had persistent thrombocytosis, her inflammatory markers (C reactive protein, ESR, interleukin 6, serum ferritin, D-dimer and procalcitonin) were elevated, and a high-resolution CT scan of the thorax at discharge revealed fibro-infiltrative patches with cavitary lesions in COVID-19 pneumonia, which are unusual findings. The patient was discharged on clinical improvement and was doing fine on follow-up after 2 weeks.<\/jats:p>","DOI":"10.1136\/bcr-2022-249466","type":"journal-article","created":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T11:05:16Z","timestamp":1655982316000},"page":"e249466","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Thrombocytosis, haemorrhagic pleural effusion and fibro-infiltrative patches with cavitary lung lesions in a child with COVID-19 pneumonia"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6022-6509","authenticated-orcid":false,"given":"Ankit","family":"Pachauri","sequence":"first","affiliation":[{"name":"Pediatrics, King George's Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shakal Narayan","family":"Singh","sequence":"additional","affiliation":[{"name":"Pediatrics, King George's Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5309-4336","authenticated-orcid":false,"given":"Sanjeev Kumar","family":"Verma","sequence":"additional","affiliation":[{"name":"Pediatrics, King George's Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shally","family":"Awasthi","sequence":"additional","affiliation":[{"name":"Pediatrics, King George's Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,6,23]]},"reference":[{"doi-asserted-by":"publisher","key":"2025082803594431000_15.6.e249466.1","DOI":"10.1111\/apa.15270"},{"key":"2025082803594431000_15.6.e249466.2","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1016\/j.cjco.2020.09.004","article-title":"Management of multisystem inflammatory syndrome in children associated with COVID-19: a survey from the International Kawasaki disease registry","volume":"2","author":"Elias","year":"2020","journal-title":"CJC Open"},{"unstructured":"Zhang Y . The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) \u2014 China, 2020. Chinese Journal of Epidemiology 2020.","key":"2025082803594431000_15.6.e249466.3"},{"doi-asserted-by":"publisher","key":"2025082803594431000_15.6.e249466.4","DOI":"10.15585\/mmwr.mm6912e2"},{"unstructured":"Dong Y , XI M , Hu Y . Epidemiological characteristics of 2143 pediatric patients with 2019 coronavirus disease in China. Pediatrics 2020:16:16.","key":"2025082803594431000_15.6.e249466.5"},{"key":"2025082803594431000_15.6.e249466.6","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.1001\/jama.2020.2131","article-title":"Novel coronavirus infection in hospitalized infants under 1 year of age in China","volume":"323","author":"Wei","year":"2020","journal-title":"JAMA"},{"doi-asserted-by":"publisher","key":"2025082803594431000_15.6.e249466.7","DOI":"10.1542\/peds.2020-1056"},{"doi-asserted-by":"crossref","unstructured":"Henry BM , Lippi G , Plebani M . Laboratory abnormalities in children with novel coronavirus disease 2019. Clin Chem Lab Med 2020:16:16.","key":"2025082803594431000_15.6.e249466.8","DOI":"10.1515\/cclm-2020-0272"},{"key":"2025082803594431000_15.6.e249466.9","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1007\/s13312-020-2026-0","article-title":"Multisystem inflammatory syndrome in children with COVID-19 in Mumbai, India","volume":"57","author":"Jain","year":"2020","journal-title":"Indian Pediatr"},{"key":"2025082803594431000_15.6.e249466.10","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1016\/j.hrtlng.2021.02.015","article-title":"The incidence of pleural effusion in COVID-19 pneumonia: state-of-the-art review","volume":"50","author":"Chong","year":"2021","journal-title":"Heart Lung"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2022-249466","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:59:54Z","timestamp":1756378794000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2022-249466"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6]]},"references-count":10,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,6,23]]},"published-print":{"date-parts":[[2022,6]]}},"alternative-id":["10.1136\/bcr-2022-249466"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2022-249466","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2022,6]]}}}