{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T10:52:38Z","timestamp":1740135158084,"version":"3.37.3"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,8,9]],"date-time":"2022-08-09T00:00:00Z","timestamp":1660003200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,8,9]],"date-time":"2022-08-09T00:00:00Z","timestamp":1660003200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Immunization against the coronavirus disease 2019 (COVID-19) began in January 2021 in Iran; nonetheless, due to a lack of vaccination among children under 12, this age group is still at risk of SARS-CoV-2 infection and its complications.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>SARS-CoV-2 infection was diagnosed in a 6-year-old girl who had previously been healthy but had developed a fever and pancytopenia. The bone marrow aspiration\/biopsy demonstrated just hypocellular marrow without signs of leukemia. She was worked up for primary and secondary causes of pancytopenia. Except for a repeated reactive HIV antibody\/Ag P24 assay, all test results were inconclusive. After a thorough diagnostic investigation, the cross-reactivity of the HIV antibody\/Ag P24 test with SARS-CoV-2 antibodies was confirmed. The patient did not develop any COVID-19-related signs and symptoms, but she did get a severe invasive fungal infection and neutropenic enterocolitis. She died as a result of disseminated intravascular coagulopathy.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>It is critical to recognize children infected with SARS-CoV-2 who exhibit atypical clinical manifestations of COVID-19, such as persistent pancytopenia. SARS-CoV-2 infection can cause severe and deadly consequences in children; thus, pediatricians should be aware of COVID-19\u2019s unusual signs and symptoms mimicking other conditions such as aplastic anemia.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12879-022-07599-6","type":"journal-article","created":{"date-parts":[[2022,8,9]],"date-time":"2022-08-09T11:03:34Z","timestamp":1660043014000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A fatal SARS-coronavirus-2 induced bone marrow aplasia complicated with invasive fungal infection and severe neutropenic enterocolitis"],"prefix":"10.1186","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9173-2853","authenticated-orcid":false,"given":"Ali","family":"Amanati","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seyyed Bozorgmehr","family":"Hedayati","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mazyar","family":"Ziyaeyan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alireza","family":"Honar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reyhaneh","family":"Dashtianeh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Negin","family":"Rabiei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nasrin","family":"Saki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leila","family":"Karami","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,8,9]]},"reference":[{"issue":"4","key":"7599_CR1","doi-asserted-by":"publisher","first-page":"536","DOI":"10.1038\/s41564-020-0695-z","volume":"5","author":"of the International CSG","year":"2020","unstructured":"of the International CSG. The species Severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2. Nat Microbiol. 2020;5(4):536.","journal-title":"Nat Microbiol"},{"issue":"2","key":"7599_CR2","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1001\/jamapediatrics.2020.4573","volume":"175","author":"RM Viner","year":"2021","unstructured":"Viner RM, Mytton OT, Bonell C, Melendez-Torres G, Ward J, Hudson L, Waddington C, Thomas J, Russell S, Van Der Klis F. Susceptibility to SARS-CoV-2 infection among children and adolescents compared with adults: a systematic review and meta-analysis. JAMA Pediatr. 2021;175(2):143\u201356.","journal-title":"JAMA Pediatr"},{"issue":"5","key":"7599_CR3","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1097\/INF.0000000000002660","volume":"39","author":"P Zimmermann","year":"2020","unstructured":"Zimmermann P, Curtis N. Coronavirus infections in children including COVID-19: an overview of the epidemiology, clinical features, diagnosis, treatment and prevention options in children. Pediatr Infect Dis J. 2020;39(5):355.","journal-title":"Pediatr Infect Dis J"},{"issue":"7","key":"7599_CR4","doi-asserted-by":"publisher","first-page":"1017","DOI":"10.1038\/s41591-020-0968-3","volume":"26","author":"A Gupta","year":"2020","unstructured":"Gupta A, Madhavan MV, Sehgal K, Nair N, Mahajan S, Sehrawat TS, Bikdeli B, Ahluwalia N, Ausiello JC, Wan EY. Extrapulmonary manifestations of COVID-19. Nat Med. 2020;26(7):1017\u201332.","journal-title":"Nat Med"},{"key":"7599_CR5","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1007\/s10238-020-00648-x","volume":"20","author":"M Gavriatopoulou","year":"2020","unstructured":"Gavriatopoulou M, Korompoki E, Fotiou D, Ntanasis-Stathopoulos I, Psaltopoulou T, Kastritis E, Terpos E, Dimopoulos MA. Organ-specific manifestations of COVID-19 infection. Clin Exp Med. 2020;20:493.","journal-title":"Clin Exp Med"},{"issue":"7","key":"7599_CR6","doi-asserted-by":"publisher","first-page":"834","DOI":"10.1002\/ajh.25829","volume":"95","author":"E Terpos","year":"2020","unstructured":"Terpos E, Ntanasis-Stathopoulos I, Elalamy I, Kastritis E, Sergentanis TN, Politou M, Psaltopoulou T, Gerotziafas G, Dimopoulos MA. Hematological findings and complications of COVID-19. Am J Hematol. 2020;95(7):834\u201347.","journal-title":"Am J Hematol"},{"doi-asserted-by":"crossref","unstructured":"Hernandez JM, Quarles R, Lakshmi S, Casanas B, Eatrides J, McCoy E, Somboonwit C. Pancytopenia and profound neutropenia as a sequela of severe SARS-CoV-2 infection (COVID-19) with concern for bone marrow involvement. In: Open Forum Infectious Diseases: 2021: Oxford University Press US; 2021: ofab017.","key":"7599_CR7","DOI":"10.1093\/ofid\/ofab017"},{"key":"7599_CR8","doi-asserted-by":"publisher","first-page":"541","DOI":"10.3324\/haematol.2021.279928","volume":"107","author":"D Avenoso","year":"2020","unstructured":"Avenoso D, Marsh JC, Potter V, Pagliuca A, Slade S, Dignan F, Tholouli E, Mittal S, Davis B, Tauro S. SARS-CoV-2 infection in aplastic anemia. Haematologica. 2020;107:541.","journal-title":"Haematologica"},{"unstructured":"Ministry of Health and Medical Education. Center for Communicable Diseases Control, Ministry of Health and Medical Education. Iranian National Guideline on managing the care and treatment of HIV\/AIDS in children. In., 4th edition. edn; 2020: 13.","key":"7599_CR9"},{"doi-asserted-by":"crossref","unstructured":"Wang F, Hou H, Luo Y, Tang G, Wu S, Huang M, Liu W, Zhu Y, Lin Q, Mao L. The laboratory tests and host immunity of COVID-19 patients with different severity of illness. JCI insight. 2020; 5(10).","key":"7599_CR10","DOI":"10.1172\/jci.insight.137799"},{"issue":"48","key":"7599_CR11","doi-asserted-by":"publisher","first-page":"eabd2071","DOI":"10.1126\/sciimmunol.abd2071","volume":"5","author":"D Weiskopf","year":"2020","unstructured":"Weiskopf D, Schmitz KS, Raadsen MP, Grifoni A, Okba NM, Endeman H, van den Akker JP, Molenkamp R, Koopmans MP, van Gorp EC. Phenotype and kinetics of SARS-CoV-2\u2013specific T cells in COVID-19 patients with acute respiratory distress syndrome. Sci Immunol. 2020;5(48):eabd2071.","journal-title":"Sci Immunol"},{"issue":"8","key":"7599_CR12","doi-asserted-by":"publisher","first-page":"875","DOI":"10.1038\/s41423-020-0483-y","volume":"17","author":"F Wang","year":"2020","unstructured":"Wang F, Hou H, Yao Y, Wu S, Huang M, Ran X, Zhou H, Liu Z, Sun Z. Systemically comparing host immunity between survived and deceased COVID-19 patients. Cell Mol Immunol. 2020;17(8):875\u20137.","journal-title":"Cell Mol Immunol"},{"issue":"12","key":"7599_CR13","doi-asserted-by":"publisher","first-page":"731","DOI":"10.1038\/s41584-021-00709-9","volume":"17","author":"C Sharma","year":"2021","unstructured":"Sharma C, Ganigara M, Galeotti C, Burns J, Berganza FM, Hayes DA, Singh-Grewal D, Bharath S, Sajjan S, Bayry J. Multisystem inflammatory syndrome in children and Kawasaki disease: a critical comparison. Nat Rev Rheumatol. 2021;17(12):731\u201348.","journal-title":"Nat Rev Rheumatol"},{"issue":"12","key":"7599_CR14","doi-asserted-by":"publisher","first-page":"1819","DOI":"10.1038\/s41591-020-1140-9","volume":"26","author":"OM Martinez","year":"2020","unstructured":"Martinez OM, Bridges ND, Goldmuntz E, Pascual V. The immune roadmap for understanding multi-system inflammatory syndrome in children: opportunities and challenges. Nat Med. 2020;26(12):1819\u201324.","journal-title":"Nat Med"},{"key":"7599_CR15","doi-asserted-by":"publisher","first-page":"364","DOI":"10.3389\/fimmu.2016.00364","volume":"7","author":"MF Pascutti","year":"2016","unstructured":"Pascutti MF, Erkelens MN, Nolte MA. Impact of viral infections on hematopoiesis: from beneficial to detrimental effects on bone marrow output. Front Immunol. 2016;7:364.","journal-title":"Front Immunol"},{"issue":"3","key":"7599_CR16","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1016\/j.cytogfr.2014.10.001","volume":"26","author":"E Brisse","year":"2015","unstructured":"Brisse E, Wouters CH, Matthys P. Hemophagocytic lymphohistiocytosis (HLH): a heterogeneous spectrum of cytokine-driven immune disorders. Cytokine Growth Factor Rev. 2015;26(3):263\u201380.","journal-title":"Cytokine Growth Factor Rev"},{"issue":"1","key":"7599_CR17","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12890-021-01706-0","volume":"21","author":"M Bordbar","year":"2021","unstructured":"Bordbar M, Sanaei Dashti A, Amanati A, Shorafa E, Mansoori Y, Dehghani SJ, Molavi Vardanjani H. Assessment of the HScore as a predictor of disease outcome in patients with COVID-19. BMC Pulm Med. 2021;21(1):1\u20139.","journal-title":"BMC Pulm Med"},{"issue":"2","key":"7599_CR18","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1007\/s002770050477","volume":"78","author":"M Osaki","year":"1999","unstructured":"Osaki M, Matsubara K, Iwasaki T, Kurata T, Nigami H, Harigaya H, Baba K. Severe aplastic anemia associated with human parvovirus B19 infection in a patient without underlying disease. Ann Hematol. 1999;78(2):83\u20136.","journal-title":"Ann Hematol"},{"issue":"9","key":"7599_CR19","doi-asserted-by":"publisher","first-page":"695","DOI":"10.7326\/0003-4819-109-9-695","volume":"109","author":"B Baranski","year":"1988","unstructured":"Baranski B, Armstrong G, Truman JT, Quinnan GV Jr, Straus SE, Young NS. Epstein-Barr virus in the bone marrow of patients with aplastic anemia. Ann Intern Med. 1988;109(9):695\u2013704.","journal-title":"Ann Intern Med"},{"issue":"1","key":"7599_CR20","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12981-015-0086-3","volume":"13","author":"P Liu","year":"2016","unstructured":"Liu P, Jackson P, Shaw N, Heysell S. Spectrum of false positivity for the fourth generation human immunodeficiency virus diagnostic tests. AIDS Res Ther. 2016;13(1):1\u20135.","journal-title":"AIDS Res Ther"},{"issue":"9","key":"7599_CR21","doi-asserted-by":"publisher","first-page":"614","DOI":"10.1136\/jclinpath-2020-206942","volume":"74","author":"SS Tan","year":"2021","unstructured":"Tan SS, Chew KL, Saw S, Jureen R, Sethi S. Cross-reactivity of SARS-CoV-2 with HIV chemiluminescent assay leading to false-positive results. J Clin Pathol. 2021;74(9):614\u2013614.","journal-title":"J Clin Pathol"},{"issue":"1","key":"7599_CR22","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1471-2180-3-20","volume":"3","author":"Y Kliger","year":"2003","unstructured":"Kliger Y, Levanon EY. Cloaked similarity between HIV-1 and SARS-CoV suggests an anti-SARS strategy. BMC Microbiol. 2003;3(1):1\u20137.","journal-title":"BMC Microbiol"},{"unstructured":"AIDS and sexually transmitted diseases, HIV in the WHO Eastern Mediterranean Region. http:\/\/www.emro.who.int\/asd\/about\/hiv-situation-region.html.","key":"7599_CR23"},{"unstructured":"Control CfD. Prevention: quick reference guide: recommended laboratory HIV testing algorithm for serum or plasma specimens. 2018. In.; 2020.","key":"7599_CR24"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-022-07599-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-022-07599-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-022-07599-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,9]],"date-time":"2022-08-09T11:04:15Z","timestamp":1660043055000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/s12879-022-07599-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,9]]},"references-count":24,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["7599"],"URL":"https:\/\/doi.org\/10.1186\/s12879-022-07599-6","relation":{},"ISSN":["1471-2334"],"issn-type":[{"type":"electronic","value":"1471-2334"}],"subject":[],"published":{"date-parts":[[2022,8,9]]},"assertion":[{"value":"13 January 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 July 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 August 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The ethics committee approved the study protocol at Professor Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences. The study protocol conformed to the ethical guidelines of the 1975 Helsinki Declaration.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient\u2019s parents to publish this case report and any accompanying images.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"682"}}