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A Case of Multisystem Inflammatory Syndrome in a Three-Year-Old Boy
Yazeid Alrefaey1, Abdulaziz F Alharbi1, Yazeed M Alzahrani2
1Medical School, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Makkah, SAU.
Insights
Multisystem inflammatory syndrome in children (MIS-C) following COVID-19 infection presents with diverse symptoms. Early diagnosis and treatment, like IVIG, lead to good outcomes in pediatric patients.
Area of Science:
- Pediatric infectious diseases
- Critical care medicine
- Rheumatology
Background:
- Multisystem inflammatory syndrome in children (MIS-C) is a serious condition linked to COVID-19.
- It typically manifests with systemic inflammation and multi-organ involvement post-SARS-CoV-2 infection.
Observation:
- A previously healthy 3-year-old boy presented with fever and diarrhea.
- He tested positive for COVID-19 and showed laboratory markers of inflammation, including lymphopenia, thrombocytopenia, elevated INR, PT, and PTT.
- Chest X-ray revealed bilateral peribronchial thickening.
Findings:
- The patient received intravenous immunoglobulin (IVIG) and supportive care.
- Clinical improvement was observed with a decrease in inflammatory markers.
- The case highlights the effectiveness of timely intervention for MIS-C.
Implications:
- MIS-C, despite its severity, generally has a favorable prognosis with appropriate management.
- Clinicians must stay updated on MIS-C guidelines for accurate diagnosis and treatment.
- Prompt management can prevent long-term sequelae in affected children.
Abstract:
Multisystem inflammatory syndrome in children (MIS-C) is being recognized in pediatric patients with COVID-19 since mid-2020. Usually, children with MIS-C have systemic symptoms that develop after an infection with SARS-CoV-2, these symptoms can be unremitting fever, gastrointestinal symptoms, skin rashes, conjunctivitis, cardiac or CNS involvement, and shock. We report a case of a three-year-old boy medically free with no prenatal or postnatal abnormalities who presented with three days history of fever and diarrhea. Upon investigation, the patient was found to be COVID-19 polymerase chain reaction (PCR) positive, also had lymphopenia, thrombocytopenia, high inflammatory markers, mildly elevated liver enzymes, high International Normalized Ratio (INR), prothrombin time (PT), partial thromboplastin time (PTT), and upon imaging bilateral peribronchial thickening was noted in a chest X-ray. The patient was treated with intravenous immunoglobulin (IVIG) and other supportive measures were also administered. Eventually, the patient improved, and his inflammatory markers dropped. He was discharged and given a follow-up appointment to further monitor his condition. The findings in this case report correlate with previously published cases that MIS-C have a good prognosis. Although, it is essential that clinicians should be updated on published cases and guidelines to better diagnose, treat, and follow-up MIS-C cases to avoid the long-term sequelae that can affect patients' lives.
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