Paediatric Inflammatory Multisystem Syndrome: A Diagnostic Challenge in a COVID-19-Negative Patient

Area of Science:

• Pediatrics
• Infectious Diseases
• Rheumatology

Background:

• Paediatric inflammatory multisystem syndrome (PIMS) is a serious condition linked to SARS-CoV-2 in individuals 19 years or younger.
• PIMS presents with fever, inflammation, and organ dysfunction, mimicking Kawasaki disease or toxic shock syndrome.
• The global SARS-CoV-2 pandemic necessitates awareness of associated conditions among clinicians.

Purpose of the Study:

• To report a case of PIMS in a young adult presenting with multi-organ failure.
• To highlight diagnostic challenges, particularly with negative SARS-CoV-2 PCR tests.
• To emphasize the importance of considering PIMS in young adults with similar presentations.

Main Methods:

• Case report of an 18-year-old female admitted with multi-organ failure.
• Differential diagnosis included toxic shock syndrome, Kawasaki disease, and PIMS.
• Diagnostic workup included SARS-CoV-2 PCR and IgG antibody testing; treatment involved methylprednisolone and IVIG.

Main Results:

• The patient presented with multi-organ failure, meeting WHO criteria for PIMS despite a negative SARS-CoV-2 PCR test.
• Positive SARS-CoV-2 IgG antibodies indicated a past infection.
• Successful treatment with methylprednisolone and intravenous immunoglobulin (IVIG) led to clinical improvement.

Conclusions:

• PIMS can occur in young adults, as demonstrated by this case.
• Multidisciplinary care is essential for effective PIMS diagnosis and management.
• PIMS shares clinical similarities with Kawasaki disease and toxic shock syndrome, requiring careful differentiation.