Tuberculosis (TB) remains a widespread infectious disease and one of the top 10 causes of death worldwide. Nevertheless, despite significant advances in the development of new drugs against tuberculosis, many therapies and preventive measures do not lead to the expected favorable health results for various reasons. The aim of this study was to evaluate the acute and sub-acute toxicity and oxidative stress of two selected nitrofuranyl amides with high in vitro antimycobacterial activity. In addition, molecular docking studies were performed on both compounds to elucidate the possibilities for further development of new anti-tuberculosis candidates with improved efficacy, selectivity, and pharmacological parameters. Acute toxicity tests showed that no changes were observed in the skin, coat, eyes, mucous membranes, secretions, and vegetative activity in mice. The histological findings include features consistent with normal histological architecture without being associated with concomitant pathological conditions. The observed oxidative stress markers indicated that the studied compounds disturbed the oxidative balance in the mouse liver. Based on the molecular docking, compound DO-190 showed preferable binding energies compared to DO-209 in three out of four targets, while both compounds showed promising protein–ligand interactions. Thus, both studied compounds displayed promising activity with low toxicity and can be considered for further evaluation and/or lead optimization.

(1) Background: Currently, multisystem inflammatory syndrome in children (MIS-C) is diagnosed based on clinical symptoms and laboratory findings of inflammation in the body. Once MIS-C is diagnosed, children will need to be followed over time. The imaging modalities most commonly used in the evaluation of patients with MIS-C include radiographs, ultrasound (US), and computed tomography (CT). Our study aims to summarise the literature data for the main gastrointestinal and pulmonary imaging features in children diagnosed with MIS-C and to share a single-centre experience. (2) Methods: We present the imaging findings in a cohort of 51 children diagnosed with MIS-C, admitted between December 2020 and February 2022. Imaging studies include chest and abdominal radiographs, thoracic, abdominal, and neck US and echocardiography (ECHO), and CT of the chest, abdomen, and pelvis. (3) Results: In accordance with the results in other studies, our observations show predominantly gastrointestinal involvement (GI) with ascites (33/51, 65%) and lymphadenopathy (19/51, 37%), ileitis or colitis (18/51, 35%), some cases of splenomegaly (9/51, 18%), hepatomegaly (8/51, 16%), and a few cases of renal enlargement (3/51, 6%) and gallbladder fossa oedema/wall thickening (2/51, 4%). Most common among the thoracic findings are posterior–basal consolidations (16/51, 31%), pleural effusion (14/51, 27%), and ground-glass opacities (12/51, 24%). We also register the significant involvement of the cardiovascular system with pericarditis (30/51, 58%), pericardial effusion (16/51, 31%), and myocarditis (6/51, 12%). (4) Conclusions: Radiologists should be aware of those imaging findings in order to take an important and active role not only in applying an accurate diagnosis, but also in the subsequent management of children with MIS-C. Radiological findings are not the primary diagnostic tool, but can assist in the evaluation of the affected systems and guide treatment.

The coronavirus pandemic first broke in December 2019. Unlike adults, children have been reported to present with milder clinical manifestations of the virus, sometimes even acting as asymptomatic carriers of infection. However, as early as mid-2020, pediatric patients who developed multisystem inflammatory syndrome (MIS-C), along with fever, cardiorespiratory symptoms and neurocognitive problems, were found to exhibit marked gastrointestinal (GI) manifestations, sometimes confounding diagnosis by mimicking GI infections, inflammatory bowel disease (IBD) or surgical contitions, such as acute appendicitis. We present series of cases of the school age children, who presented with severe abdominal pain during Bulgaria’s first peak of COVID-19 pandemic. Characteristic symptoms of the disease – disosmia, nausea, vomiting, loss of appetite were reported to occur 2 weeks prior to hospitalization and were only mild or barely causing any concern to the parent. Children were admitted with symptoms of mild to moderate dehydration, metabolic acidosis and often constipation. The classical laboratory findings of elevated inflammatory response, leucopenia and lymphopenia were absent. Abdominal ultrasound was negative. Repeated surgical exams revealed no signs of acute abdomen. Qualitative antibody testing showed either presence of both IgM and IgG antibodies against SARS CoV-2 or only IgG antibodies. Some children had pathologic urinary findings, such as hematuria. Signs of autonomic dysfunction were observed since all of the patients had bradycardia and variations of blood pressure. No respiratory symptoms were registered and no children Had no history of pre-existing conditions. Symptomatic medication was effective only in some patients. Empiric AB-treatment proved to be much more successful, though no causative agent of intestinal infection was isolated. Manifestations of post-infectious MIS-C, associated with COVID-19 often include gastro-intestinal symptoms. For definitive diagnosis of the condition, tests for COVID-19 should be administered, since not all laboratory findings might be consistent with case definitions.