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.