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Published on: August 12, 2020
Critically ill infant with multisystem inflammatory syndrome related to COVID-19
Arturo A Canul-Euan1,2, Gabriela Solís-Jiménez1
1Unidad de Terapia Intensiva Pediátrica, Hospital General Regional No. 220 General José Vicente Villada, Instituto Mexicano del Seguro Social, Toluca, State of Mexico. Mexico.
Insights
Severe COVID-19 is rare in infants, but this case highlights a critical multisystem inflammatory syndrome in an 8-month-old. Early consideration of SARS-CoV-2 is vital for prompt diagnosis and management in critically ill infants.
Area of Science:
- Pediatric Infectious Diseases
- Global Public Health
- Critical Care Medicine
Background:
- COVID-19 poses a global health threat, with severe presentations uncommon in children.
- Multisystem inflammatory syndrome in infants linked to COVID-19 requires careful consideration.
IntroduccióN:
La COVID-19 se ha convertido en una amenaza para la salud pública mundial. Sin embargo, las formas graves en niños son poco frecuentes. Se presenta el caso de un lactante con síndrome inflamatorio multisistémico relacionado con COVID-19.
Caso ClíNico:
Lactante de 8 meses que estuvo en contacto con adultos positivos para COVID-19. El lactante inició con una forma leve de la enfermedad que progresó con rapidez a una forma crítica de presentación inicialmente con estado epiléptico, y a su ingreso con evidencia de inflamación en laboratorios, afección sistémica grave con falla multiorgánica y prueba de reacción en cadena de la polimerasa para SARS-CoV-2 nasofaríngea positiva. El lactante falleció 7 días después de su ingreso.
Conclusiones:
El espectro de presentación de la COVID-19 en niños menores de 1 año es variable y aún no se cuentan con criterios consensuados para el diagnóstico y el tratamiento. Todo lactante con enfermedad grave con compromiso multiorgánico al ingreso en tiempos de pandemia obliga a realizar una meticulosa historia clínica y considerar la infección por SARS-CoV-2 hasta su confirmación.
Background:
COVID-19 has become a threat to global public health. However, severe forms of COVID-19 presentation in children are rare. We present the case of an infant with COVID 19-related multisystem inflammatory syndrome.
Case Report:
We describe the case of an 8-month-old infant who had contact with COVID-19 positive adults. The infant began with mild symptoms of the disease but rapidly progressed to a critical form of presentation:initially with epileptic status, and upon admission with laboratory evidence of inflammation, severe systemic condition with multiple organ failure, and a positive nasopharyngeal SARS-CoV-2 PCR test. The infant died 7 days after admission.
Conclusions:
The spectrum of COVID-19 presentation in children under one year of age is variable, and there are still no established criteria for diagnosis and treatment. All infants presenting a severe disease with multiple organ involvement at admission in times of pandemic require a thorough medical history to consider SARS-CoV-2 infection until proven otherwise.
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