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A Case of Complete Heart Block and Acute Appendicitis in a Young Patient With COVID-19

Sherin Sallam1, Claire Sullivan2

  • 1Department of Internal Medicine, University Hospitals Cleveland Medical Center, Cleveland, USA.

Cureus
|April 11, 2022
PubMed

Insights

A 19-year-old experienced severe COVID-19 complications, including appendicitis and heart block, mimicking multisystem inflammatory syndrome in children (MIS-C). Early recognition of these rare extrapulmonary symptoms is vital for patient outcomes.

Area of Science:

  • Internal Medicine
  • Cardiology
  • Infectious Diseases

Background:

  • Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, presents diagnostic challenges due to diverse extrapulmonary manifestations.
  • Research into the full spectrum of COVID-19 presentations is ongoing, complicating early recognition and management.

Observation:

  • A 19-year-old male with COVID-19 developed acute abdominal pain, bradycardia, fever, and elevated inflammatory markers.
  • Diagnostic imaging revealed appendicitis, while an electrocardiogram showed third-degree heart block.

Findings:

  • The patient's presentation mimicked multisystem inflammatory syndrome in children (MIS-C), a known complication of SARS-CoV-2, but occurred in an adult.
  • Successful pacemaker implantation was performed, and appendectomy was planned.

Implications:

  • This case highlights the importance of considering MIS-C-like systemic inflammation in adults with COVID-19.
  • Prompt recognition and appropriate management of these rare manifestations can significantly improve patient outcomes.

Keywords:
appendicitiscomplete heart blockcovid-19mis-cmultisystem inflammatory syndrome in childrensars-cov-2third-degree av block

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