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Case Report: Simil-Appendicitis Presentation May Precede Cardiac Involvement in MIS-C Patient
Matteo Trevisan1, Alessandro Amaddeo2, Andrea Taddio1,2
1Department of Medicine, Surgery, and Health Sciences, University of Trieste, Trieste, Italy.
Frontiers in Pediatrics
|March 24, 2022
Summary
Multisystem inflammatory syndrome in children (MIS-C) can mimic appendicitis, presenting with gastrointestinal symptoms and fever. Early recognition of MIS-C, even without cardiac signs, is crucial for timely treatment and preventing complications.
Area of Science:
- Pediatric infectious diseases
- Pediatric critical care medicine
- Pediatric rheumatology
Background:
- Multisystem inflammatory syndrome in children (MIS-C) is a hyperinflammatory condition linked to SARS-CoV-2 infection.
- Gastrointestinal symptoms are common in MIS-C, but presentations can vary.
- Appendicitis-like symptoms are a rare but critical presentation of MIS-C.
Observation:
- A 15-year-old boy presented with fever, vomiting, and abdominal pain, initially suspected as appendicitis.
- Initial laparoscopy revealed no surgical cause, but symptoms persisted.
- Subsequent cardiac evaluation showed inflammatory markers and QTc prolongation, leading to MIS-C diagnosis.
Findings:
- MIS-C diagnosis was confirmed by systemic inflammation involving multiple organs post-SARS-CoV-2 infection.
- Intravenous immunoglobulin and steroid treatment led to rapid clinical recovery.
- Cardiac abnormalities resolved within three weeks of treatment.
Implications:
- Physicians should consider MIS-C in children presenting with appendicitis-like symptoms, especially with lymphopenia and ileus.
- Prompt diagnosis and treatment of MIS-C are essential to prevent severe complications, particularly cardiac involvement.
- Awareness of atypical MIS-C presentations improves patient outcomes and reduces misdiagnosis.
