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Multisystem inflammatory syndrome in children (MIS-C) of a toddler initially presenting with fever and pyuria

Kinyui Alice Lo1, Lee Gan Goh2,3, Rajeev Ramachandran4,5

  • 1Department of Family Medicine, National University Health System, Singapore lokinyui@gmail.com.

BMJ Case Reports
|January 3, 2024
PubMed

Insights

This case study details multisystem inflammatory syndrome in children (MIS-C) in a young East Asian toddler, presenting uniquely with pyuria. Early diagnosis and treatment are crucial, though coronary abnormalities may persist.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Cardiology

Background:

  • Multisystem inflammatory syndrome in children (MIS-C) is a rare but serious condition following SARS-CoV-2 infection.
  • Early recognition is vital for timely intervention and management of potential complications.

Observation:

  • A young East Asian toddler presented with fever, pyuria, conjunctivitis, and extremity changes 5 weeks post-COVID-19 recovery.
  • Initial symptoms mimicked a urinary tract infection, delaying MIS-C diagnosis.

Findings:

  • Laboratory results revealed elevated inflammatory markers, thrombocytopenia, and markedly elevated NT-proBNP.
  • Despite prompt inpatient treatment, mild coronary abnormalities were noted 9 months post-discharge.

Implications:

  • This case highlights the diverse presentations of MIS-C, including pyuria, and its occurrence in specific demographics.
  • Emphasizes the need for heightened clinical suspicion for MIS-C in children with post-viral febrile illnesses, even with atypical initial symptoms.

Keywords:
COVID-19PaediatricsPrimary CareUrinary tract infections

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