Purpose: To report a case of pseudotumor cerebri (PTC) in a child associated with multisystem inflammatory syndrome in children (MIS-C), associated with presumed coronavirus disease 2019. Methods: A previously healthy 11-year-old female child presented with a 4-day history of fever, headache, vomiting, and loose stools. Laboratory investigations revealed neutrophilic leukocytosis, and markers of inflammation (C-reactive protein, ferritin, and interleukin-6) were significantly elevated. Pharyngeal swab for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by polymerase chain reaction was negative while anti-SARS-CoV-2 antibody was highly reactive. Ophthalmic evaluation for transient visual obscurations during hospital course revealed swelling of the optic disc in both eyes. Spectral-domain optical coherence tomography and ultrasonography confirmed the ophthalmoscopic findings. There was no neurologic deficit. Magnetic resonance imaging of the brain and magnetic resonance venogram revealed no structural lesion. The opening pressure of cerebrospinal fluid (CSF) was 336 mm of water, and CSF composition was normal. Results: A diagnosis of PTC associated with MIS-C was made, and the child was treated with oral acetazolamide. Edema of the optic disc regressed following therapy, and the child is under follow-up. Conclusions: PTC can occur in association with MIS-C. Clinicians need to be aware of this potential neuro-ophthalmic complication in MIS-C. Prompt diagnosis and treatment can prevent visual loss.

Background: Coronavirus disease 2019 (COVID-19), in children has varied clinical presentations from asymptomatic infection to severe pneumonia, multi system inflammatory syndrome in children (MIS-C) and rarely death. To date, limited data has been published on the profile of COVID-19 infection among Indian children. The objective of this study was to analyze the clinical spectrum, laboratory parameters, treatment and it’s outcome in children less than 15 years admitted with COVID-19 infection.Methods: This was a cross sectional study done in a tertiary care hospital. Children with COVID-19 infection detected by Reverse transcriptase polymerase chain reaction (RT-PCR) were included.  Results: Out of 167 children, 93 were males (55.6%) and median (Interquartile range- IQR) age of children admitted were 9 (4-13) years. Family cluster (71%) was the dominant source of infection. Majority were asymptomatic (60%, N=100). The predominant symptoms were fever (29%), cough (16%) and rhinorrhea (4.1%). Seven (4.1%) children had comorbidities and two (28%) among them had moderate to severe disease. Median (IQR) total leucocyte count was 7 (4-10) ×103 µl and platelet count was 390 (275-500) ×103 µl. Leukopenia was observed in 58% (N=81), lymphocytosis in 32.8% (N=46) and thrombocytopenia in 3.5% (N=5). Inflammatory markers were raised in 10-15% of children. Peri-bronchial cuffing was the common abnormality (N=14, 17.5%) in chest X-ray (CXR) and peripheral heterogeneous opacities were noted in severe disease. Children with moderate to severe symptoms were treated with remdesivir and steroids.Conclusions: COVID-19 infection in children was often benign and increased severity was noted among those with comorbidities. Leukopenia, lymphocytosis were commonly observed. High inflammatory markers were noted in severe disease. Nil fatality among our study group.