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Severe Neurological Manifestation in a Child with Multisystem Inflammatory Syndrome
Mônica de Oliveira Santos1, Diuly Caroline Ribeiro2, Jordanna Sousa Rocha2
1Clinical Pathology and Medicine, Federal University of Goiás, Goiânia 74690-900, GO, Brazil.
Insights
Multisystem Inflammatory Syndrome in Children (MIS-C) can cause severe neurological complications, including ischemic stroke, in healthy children. Early diagnosis and treatment with corticosteroids and immunoglobulin are crucial for a positive outcome.
Area of Science:
- Pediatric infectious diseases
- Pediatric critical care medicine
- Pediatric neurology
Background:
- The COVID-19 pandemic has seen an increase in Multisystem Inflammatory Syndrome in Children (MIS-C).
- MIS-C is a serious condition that can affect multiple organ systems in children.
- Understanding the evolution and complications of MIS-C is vital for effective management.
Observation:
- A previously healthy 3-year-old girl diagnosed with MIS-C presented with neurological complications.
- The patient experienced hematological alterations, transient cardiac dysfunction, and cerebral involvement including ischemic stroke with laminar cortical necrosis.
- Severe subglottic stenosis developed post-extubation, indicated by dysphonia and stridor.
Findings:
- Neurological complications, such as ischemic stroke, can occur in MIS-C patients.
- Subglottic stenosis is a potential complication following prolonged intubation in MIS-C patients.
- Early recognition and prompt treatment of MIS-C are associated with better clinical outcomes.
Implications:
- This case highlights the potential for severe neurological manifestations of MIS-C in previously healthy children.
- Awareness of potential complications like subglottic stenosis is important for post-extubation care.
- Aggressive early treatment with corticosteroids and immunoglobulin may improve outcomes for children with MIS-C and neurological involvement.
Background And Objectives:
During the COVID-19 pandemic, we followed with concern the evolution of several children diagnosed with Multisystem Inflammatory Syndrome in Children (MIS-C). The purpose of this study is to describe the evolution of MIS-C in a previously healthy 3-year-old girl.
Methods:
We tracked the daily medical report of all children admitted with suspected MIS-C to the five largest regional hospitals.
Results:
Our screening identified a child who had several neurological complications associated with MIS-C. We report hematological alterations, transient cardiac dysfunction, and cerebral involvements such as laminar cortical necrosis caused by ischemic stroke. We present the course of treatment and clinical outcome, and other complications such as a severe subglottic stenosis occurring after extubation.
Conclusion:
Subglottic stenosis is an expected complication after prolonged intubation, and the presence of dysphonia and/or stridor is an important predictive factor. MIS-C with severe neurological alteration may occur in a healthy child, and early diagnosis and treatment with a pulse of corticoid with immunoglobulin are essential for a favorable outcome.
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