Multisystem Inflammatory Syndrome with Features of Atypical Kawasaki Disease during COVID-19 Pandemic
- PDF / 327,814 Bytes
- 3 Pages / 595.276 x 790.866 pts Page_size
- 5 Downloads / 216 Views
CLINICAL BRIEF
Multisystem Inflammatory Syndrome with Features of Atypical Kawasaki Disease during COVID-19 Pandemic Abdul Rauf 1
&
Ajay Vijayan 1 & Shaji Thomas John 1 & Raghuram Krishnan 2 & Abdul Latheef 3
Received: 8 May 2020 / Accepted: 15 May 2020 # Dr. K C Chaudhuri Foundation 2020
Abstract There is a global concern of increasing number of children presenting with inflammatory syndrome with clinical features simulating Kawasaki disease, during ongoing COVID-19 pandemic. The authors report a very similar case of 5-y-old boy from a COVID-19 hotspot area who presented in late April 2020 with acute febrile illness with abdominal pain and loose stools followed by shock. On examination, child had bulbar conjunctivitis and extremity edema. Initial investigations showed high inflammatory parameters, elevated serum creatinine and liver enzymes. Echocardiography showed moderate LV dysfunction and normal coronaries. Cardiac enzymes were also elevated, suggesting myocarditis. He was treated with inotropic support, respiratory support with high flow nasal cannula, IV immunoglobulins, aspirin, steroids and diuretics. RT PCR for SARS-CoV-2 was negative twice. His clinical condition improved rapidly, was afebrile from day 2, inflammatory parameters decreased, left ventricular function improved and was discharged after 6 d of hospital stay. Keywords Kawasaki disease . Inflammatory syndrome . COVID-19 . Multi-organ dysfunction . Children
Introduction Kawasaki disease (KD) is the most common systemic vasculitis in children, predominantly affecting the medium sized and small vessels [1]. The exact etiology of KD being not clear, it is believed that some infectious agent can trigger clinically apparent disease in individuals with certain genetic predisposition [2]. COVID-19 infection in children is less severe and has lesser mortality, compared to adults. However, National Health System (NHS) of United Kingdom and Pediatric Intensive Care Society (PICS) issued an alert recently regarding occurrence of around 20 cases of so called Pediatric multisystem inflammatory syndrome temporally associated with COVID19 [3]. This syndrome shared overlapping features with other * Abdul Rauf [email protected] 1
Department of Pediatrics, Baby Memorial Hospital, Calicut, Kerala 673004, India
2
Department of Cardiology, Baby Memorial Hospital, Calicut, Kerala, India
3
Department of Pediatrics, Santi Hospital, Omassery, Calicut, Kerala, India
pediatric inflammatory conditions like KD and toxic shock syndromes. The authors report a very similar case of 5-y-old boy from a COVID infection hotspot area in Kerala state of India who presented in April 2020 with multi- organ dysfunction.
Case Report A previously well 5-y-old boy presented with acute febrile illness without any obvious foci. On day 3 of illness, a urine routine examination showed pyuria and he was started on oral antibiotics. He continued to have high grade fever spikes and developed severe crampy abdominal pain with loose stools on day 5. USG abdomen done in a peripheral h
Data Loading...
