Multisystem Inflammatory Syndrome with Features of Atypical Kawasaki Disease during COVID-19 Pandemic

Area of Science:

• Pediatrics
• Infectious Diseases
• Cardiology

Background:

• The COVID-19 pandemic has been associated with a rise in pediatric inflammatory syndromes resembling Kawasaki disease.
• Early identification and management are crucial for favorable outcomes in affected children.

Observation:

• A 5-year-old boy presented with acute febrile illness, abdominal pain, diarrhea, and shock.
• Clinical signs included conjunctivitis and extremity edema, with laboratory findings of elevated inflammatory markers, creatinine, and liver enzymes.
• Echocardiography revealed left ventricular dysfunction and elevated cardiac enzymes, suggesting myocarditis.

Findings:

• The patient received treatment including inotropic support, respiratory support, intravenous immunoglobulins, aspirin, steroids, and diuretics.
• Despite two negative SARS-CoV-2 RT-PCR tests, the clinical presentation was consistent with a COVID-19-associated inflammatory syndrome.
• The child showed rapid clinical improvement, with resolution of fever, decreased inflammation, and improved cardiac function within 6 days.

Implications:

• This case underscores the importance of considering COVID-19-associated inflammatory syndromes in children presenting with Kawasaki-like symptoms, even with negative viral tests.
• Prompt and comprehensive management can lead to successful recovery.
• Further research is needed to elucidate the precise mechanisms and long-term effects of these syndromes.