Neonatal MIS-C: Managing the Cytokine Storm

Area of Science:

• Neonatology
• Pediatric Infectious Diseases
• Critical Care Medicine

Background:

• Late-onset sepsis and persistent thrombocytopenia were initially diagnosed in a term infant.
• The infant presented with recurrent fever, diarrhea, and a maculopapular rash, prompting further investigation.

Observation:

• COVID-19 infection was confirmed via RT-PCR in the infant.
• The infant rapidly developed cardiogenic shock, pulmonary edema, anemia, and thrombocytopenia, requiring mechanical ventilation.

Findings:

• Diagnosis of multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19 was made.
• The infant experienced seizures, pulmonary hemorrhage, cardiac arrest, and acute kidney injury, indicating severe systemic involvement.
• Refractory myocarditis, gastrointestinal, and renal manifestations were prominent features of this neonatal MIS-C case.

Implications:

• This case underscores the potential for severe, multi-organ system disease in neonates with COVID-19.
• It highlights the diagnostic challenges and critical care needs in neonatal MIS-C.
• The unique dermatologic manifestations in neonatal COVID-19 warrant further study.