Abstract:
The COVID-19 pandemic has posed significant challenges to the pediatric oncology population. The effects of the virus on pediatric neurooncology patients are not yet well described. We present the case of a pediatric patient with medulloblastoma and SARS-CoV-2 infection (CV) who developed posterior reversible encephalopathy syndrome (PRES) and necrotizing enterocolitis (NEC). An 8-year-old male with group 4 medulloblastoma metastatic to the brain and spine underwent debulking and standard treatment. During cycle 3, he developed symptomatic CV. Seventeen days later, he began cycle 4 after appropriate count recovery. Twenty-six days after last positive CV test during a hospitalization for chemotherapy complications, the patient developed vertical nystagmus. His neurological exam quickly deteriorated with imaging supporting PRES. Repeat CV testing confirmed viral presence. The patient subsequently developed NEC after upgrading to the intensive care unit and endured multiple bedside procedures, after which the decision to withdraw support was made. This case highlights the increased risks this vulnerable population experiences and reiterates the importance of early identification and treatment of CV sequelae.