Case Report: Crying-triggered pallid and hypotonic episodes in a 6-week-old infant with SARS-CoV-2 infection—a diagnostic dilemma
- 1Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, Jiangsu, China
Abstract
Crying-triggered pallid and hypotonic episodes in early infancy can be difficult to classify. We report a 44-day-old term female infant with acute severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who experienced two crying-triggered episodes of marked pallor, limpness, and reduced responsiveness after cessation of crying, followed by spontaneous recovery. Neither event was physiologically recorded, and a definitive cause could not be established. No further episodes were reported during hospitalization or 8 weeks of follow-up. The clinical sequence suggested breath-holding spells (BHS) as one possible explanation alongside infection-associated apnea and other causes of paroxysmal events in early infancy. This case highlights the need for careful differential diagnosis of crying-triggered pallid and hypotonic episodes occurring during acute SARS-CoV-2 infection.
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BibTeX
@article{wang2026case,
title = {{Case Report: Crying-triggered pallid and hypotonic episodes in a 6-week-old infant with SARS-CoV-2 infection—a diagnostic dilemma}},
author = {Shun Wang and Sainan Chen and Yuqing Wang},
journal = {Frontiers in Pediatrics},
year = {2026},
month = oct,
doi = {10.3389/fped.2026.1989655},
url = {https://doi.org/10.3389/fped.2026.1989655},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Case Report: Crying-triggered pallid and hypotonic episodes in a 6-week-old infant with SARS-CoV-2 infection—a diagnostic dilemma
AU - Shun Wang
AU - Sainan Chen
AU - Yuqing Wang
PY - 2026
DA - 2026/10/22
JO - Frontiers in Pediatrics
DO - 10.3389/fped.2026.1989655
UR - https://doi.org/10.3389/fped.2026.1989655
AB - Crying-triggered pallid and hypotonic episodes in early infancy can be difficult to classify. We report a 44-day-old term female infant with acute severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who experienced two crying-triggered episodes of marked pallor, limpness, and reduced responsiveness after cessation of crying, followed by spontaneous recovery. Neither event was physiologically recorded, and a definitive cause could not be established. No further episodes were reported during hospitalization or 8 weeks of follow-up. The clinical sequence suggested breath-holding spells (BHS) as one possible explanation alongside infection-associated apnea and other causes of paroxysmal events in early infancy. This case highlights the need for careful differential diagnosis of crying-triggered pallid and hypotonic episodes occurring during acute SARS-CoV-2 infection.
SN - 2296-2360
ER -