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Is It Stevens-Johnson Syndrome or MIS-C with Mucocutaneous Involvement?
Abdollah Karimi1, Elham Pourbakhtiaran1, Mazdak Fallahi2
1Pediatric Infections Research Center, Research Institute for Children's Health, ShahidBeheshti University of Medical Sciences, Tehran, Iran.
Insights
Multisystem inflammatory syndrome in children (MIS-C) can manifest with diverse symptoms, including skin rashes, during COVID-19. Early recognition and treatment of MIS-C are crucial for pediatric patients presenting with fever and dermatological features.
Area of Science:
- Pediatrics
- Infectious Diseases
- Dermatology
Background:
- Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) can trigger multisystem inflammatory syndrome in children (MIS-C).
- The COVID-19 pandemic has seen an increase in pediatric cases presenting with inflammatory conditions.
Observation:
- A 25-month-old boy presented with fever, malaise, diffuse maculopapular rashes, and mucosal involvement.
- Initial diagnosis was Stevens-Johnson syndrome (SJS), but subsequent tests revealed lymphopenia, thrombocytopenia, and elevated inflammatory markers.
- The patient later tested positive for SARS-CoV-2 via PCR.
Findings:
- The child exhibited laboratory findings including lymphopenia, thrombocytopenia, and elevated C-reactive protein (CRP), ferritin, and fibrinogen.
- Treatment for MIS-C, alongside initial SJS care, led to the patient's recovery within four days.
Implications:
- COVID-19 should be considered in children presenting with fever and dermatological symptoms during the pandemic.
- MIS-C can present with varied clinical features, potentially indicating a delayed hyperimmune response to SARS-CoV-2 infection.
- Prompt diagnosis and management of MIS-C are essential for favorable outcomes in pediatric patients.
Background:
Severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) can be present in the form of multisystem inflammatory disease in children.
Case Presentation:
A 25-month-old boy presented with fever, malaise, diffuse maculopapular rashes, and mucosal involvement during the COVID-19 pandemic. He was first diagnosed with Stevens-Johnson syndrome (SJS). Further evaluation revealed lymphopenia, thrombocytopenia, and elevated levels of C-reactive protein (CRP), ferritin, and fibrinogen. This was followed by a positive polymerase chain reaction (PCR) test for COVID-19. In addition to receiving initial care for SJS, he was treated for MIS-C, which led to his recovery after four days.
Conclusion:
COVID-19 infection should be considered in children with fever and dermatological features during the pandemic because it may cause different features of the multisystem inflammatory syndrome in children (MIS-C), suggestive of delayed hyperimmune response.
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