SARS-CoV-2-associated inflammatory multisystem disease in a 15-year-old boy

Area of Science:

• Pediatric critical care medicine
• Infectious diseases
• Rheumatology

Background:

• Emergence of novel multisystem inflammatory syndromes in children following SARS-CoV-2 infection.
• Recognition of paediatric inflammatory multisystem syndrome (PIMS) as a distinct entity mimicking Kawasaki disease.
• Challenges in diagnosing PIMS due to negative viral RNA detection at presentation.

Observation:

• A 15-year-old male presented with high fever, rash, conjunctivitis, abdominal pain, septic shock, and multiorgan failure.
• The patient had a history of mild SARS-CoV-2 infection weeks prior to admission.
• Direct SARS-CoV-2 detection was negative, but IgG antibodies confirmed prior infection.

Findings:

• The patient received intensive care including immunoglobulin, aspirin, and steroid therapy.
• Clinical stabilization and complete recovery without sequelae were achieved.
• This case represents one of the earliest documented PIMS cases in Hungary.

Implications:

• PIMS is an important consideration in pediatric patients with severe sepsis and multiorgan failure post-SARS-CoV-2.
• Serological testing is crucial for diagnosing PIMS when viral detection is negative.
• Prompt, targeted therapy is essential for favorable outcomes in PIMS patients.