A Case of Multisystem Inflammatory Syndrome in a Three-Year-Old Boy

Abstract

Multisystem inflammatory syndrome in children (MIS-C) is being recognized in pediatric patients with COVID-19 since mid-2020. Usually, children with MIS-C have systemic symptoms that develop after an infection with SARS-CoV-2, these symptoms can be unremitting fever, gastrointestinal symptoms, skin rashes, conjunctivitis, cardiac or CNS involvement, and shock. We report a case of a three-year-old boy medically free with no prenatal or postnatal abnormalities who presented with three days history of fever and diarrhea. Upon investigation, the patient was found to be COVID-19 polymerase chain reaction (PCR) positive, also had lymphopenia, thrombocytopenia, high inflammatory markers, mildly elevated liver enzymes, high International Normalized Ratio (INR), prothrombin time (PT), partial thromboplastin time (PTT), and upon imaging bilateral peribronchial thickening was noted in a chest X-ray. The patient was treated with intravenous immunoglobulin (IVIG) and other supportive measures were also administered. Eventually, the patient improved, and his inflammatory markers dropped. He was discharged and given a follow-up appointment to further monitor his condition. The findings in this case report correlate with previously published cases that MIS-C have a good prognosis. Although, it is essential that clinicians should be updated on published cases and guidelines to better diagnose, treat, and follow-up MIS-C cases to avoid the long-term sequelae that can affect patients' lives.

Severe Agitation as an Unusual Presentation of Multisystem Inflammatory Syndrome in Children

“…IVIG has been shown to be effective in treating MIS-C. Corticosteroids can be used based on the case and the followed guidelines. However, MIS-C management is multidisciplinary, and treatment should be individualized according to the system involved [12]. Long-term follow-up is essential, especially in children who have experienced complications [12].…”

“…However, MIS-C management is multidisciplinary, and treatment should be individualized according to the system involved [12]. Long-term follow-up is essential, especially in children who have experienced complications [12]. The successful response for IVIG in treating MIS-C and Kawasaki disease suggests that antibodies likely have a role in the pathophysiology, but the exact role of antibodies is still unknown [13].…”