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Published in: BMC Infectious Diseases 1/2020

Open Access 01-12-2020 | Conjunctivitis | Case report

A young adult with COVID-19 and multisystem inflammatory syndrome in children (MIS-C)-like illness: a case report

Authors: Aaron D. Kofman, Emma K. Sizemore, Joshua F. Detelich, Benjamin Albrecht, Anne L. Piantadosi

Published in: BMC Infectious Diseases | Issue 1/2020

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Abstract

Background

A healthy 25-year-old woman developed COVID-19 disease with clinical characteristics resembling Multisystem Inflammatory Syndrome in Children (MIS-C), a rare form of COVID-19 described primarily in children under 21 years of age.

Case presentation

The patient presented with 1 week of weakness, dyspnea, and low-grade fevers, followed by mild cough, sore throat, vomiting, diarrhea, and lymph node swelling. She was otherwise healthy, with no prior medical history. Her hospital course was notable for profound acute kidney injury, leukocytosis, hypotension, and cardiac dysfunction requiring ICU admission and vasopressor support. MIS-C-like illness secondary to COVID-19 was suspected due to physical exam findings of conjunctivitis, mucositis, and shock. She improved following IVIG, aspirin, and supportive care, and was discharged on hospital day 5.

Conclusion

MIS-C-like illness should be considered in adults presenting with atypical clinical findings and concern for COVID-19. Further research is needed to support the role of IVIG and aspirin in this patient population.
Literature
1.
go back to reference Kawasaki T. Acute febrile mucocutaneous syndrome with lymphoid involvement with specific desquamation of the fingers and toes in children. Japanese J Allergol. 1967;16:178. Kawasaki T. Acute febrile mucocutaneous syndrome with lymphoid involvement with specific desquamation of the fingers and toes in children. Japanese J Allergol. 1967;16:178.
2.
go back to reference Riphagen S, Gomez X, Gonzalez-Martinez C, Wilkinson N, Theocharis P. Hyperinflammatory shock in children during COVID-19 pandemic. Lancet. 2020;395:1607.CrossRef Riphagen S, Gomez X, Gonzalez-Martinez C, Wilkinson N, Theocharis P. Hyperinflammatory shock in children during COVID-19 pandemic. Lancet. 2020;395:1607.CrossRef
3.
go back to reference Verdoni L, Mazza A, Gervasoni A, Martelli L, Ruggeri M, Ciuffreda M, et al. An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: an observational cohort study. Lancet. 2020;395:1771.CrossRef Verdoni L, Mazza A, Gervasoni A, Martelli L, Ruggeri M, Ciuffreda M, et al. An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: an observational cohort study. Lancet. 2020;395:1771.CrossRef
4.
go back to reference Feldstein LR, Rose EB, Horwitz SM, Collins JP, Newhams MM, Son MBF, et al. Multisystem Inflammatory Syndrome in U.S. Children and Adolescents. N Engl J Med. 2020;383:334.CrossRef Feldstein LR, Rose EB, Horwitz SM, Collins JP, Newhams MM, Son MBF, et al. Multisystem Inflammatory Syndrome in U.S. Children and Adolescents. N Engl J Med. 2020;383:334.CrossRef
6.
go back to reference Ovanesov MV, Menis MD, Scott DE, Forshee R, Anderson S, Bryan W, et al. Association of immune globulin intravenous and thromboembolic adverse events. Am J Hematol. 2017;92:E44.CrossRef Ovanesov MV, Menis MD, Scott DE, Forshee R, Anderson S, Bryan W, et al. Association of immune globulin intravenous and thromboembolic adverse events. Am J Hematol. 2017;92:E44.CrossRef
7.
go back to reference Hennon TR, Penque MD, Abdul-Aziz R, Alibrahim OS, McGreevy MB, Prout AJ, et al. COVID-19 associated multisystem inflammatory syndrome in children (MIS-C) guidelines; a Western New York approach. Prog Pediatr Cardiol. 2020;57:101232. Hennon TR, Penque MD, Abdul-Aziz R, Alibrahim OS, McGreevy MB, Prout AJ, et al. COVID-19 associated multisystem inflammatory syndrome in children (MIS-C) guidelines; a Western New York approach. Prog Pediatr Cardiol. 2020;57:101232.
8.
go back to reference Dallaire F, Fortier-Morissette Z, Blais S, Dhanrajani A, Basodan D, Renaud C, et al. Aspirin dose and prevention of coronary abnormalities in Kawasaki disease. Pediatrics. 2017;139:e20170098.CrossRef Dallaire F, Fortier-Morissette Z, Blais S, Dhanrajani A, Basodan D, Renaud C, et al. Aspirin dose and prevention of coronary abnormalities in Kawasaki disease. Pediatrics. 2017;139:e20170098.CrossRef
9.
go back to reference Platt B, Belarski E, Manaloor J, Ofner S, Carroll AE, John CC, et al. Comparison of risk of recrudescent fever in children with kawasaki disease treated with intravenous immunoglobulin and low-dose vs high-dose aspirin. JAMA Netw Open. 2020;3:e1918565.CrossRef Platt B, Belarski E, Manaloor J, Ofner S, Carroll AE, John CC, et al. Comparison of risk of recrudescent fever in children with kawasaki disease treated with intravenous immunoglobulin and low-dose vs high-dose aspirin. JAMA Netw Open. 2020;3:e1918565.CrossRef
10.
go back to reference Xia J, Tong J, Liu M, Shen Y, Guo D. Evaluation of coronavirus in tears and conjunctival secretions of patients with SARS-CoV-2 infection. J Med Virol. 2020;92:589.CrossRef Xia J, Tong J, Liu M, Shen Y, Guo D. Evaluation of coronavirus in tears and conjunctival secretions of patients with SARS-CoV-2 infection. J Med Virol. 2020;92:589.CrossRef
11.
go back to reference Dufort EM, Koumans EH, Chow EJ, Rosenthal EM, Muse A, Rowlands J, et al. Multisystem inflammatory syndrome in children in New York State. N Engl J Med. 2020;383:347.CrossRef Dufort EM, Koumans EH, Chow EJ, Rosenthal EM, Muse A, Rowlands J, et al. Multisystem inflammatory syndrome in children in New York State. N Engl J Med. 2020;383:347.CrossRef
12.
go back to reference Miller J, Cantor A, Zachariah P, Ahn D, Martinez M, Margolis K. Gastrointestinal symptoms as a major presentation component of a novel multisystem inflammatory syndrome in children (MIS-C) that is related to COVID-19: a single center experience of 44 cases. Gastroenterology. 2020;S0016-5085:34753. Miller J, Cantor A, Zachariah P, Ahn D, Martinez M, Margolis K. Gastrointestinal symptoms as a major presentation component of a novel multisystem inflammatory syndrome in children (MIS-C) that is related to COVID-19: a single center experience of 44 cases. Gastroenterology. 2020;S0016-5085:34753.
13.
go back to reference Belhadjer Z, Méot M, Bajolle F, Khraiche D, Legendre A, Abakka S, et al. Acute heart failure in multisystem inflammatory syndrome in children (MIS-C) in the context of global SARS-CoV-2 pandemic. Circulation. 2020;142:429. Belhadjer Z, Méot M, Bajolle F, Khraiche D, Legendre A, Abakka S, et al. Acute heart failure in multisystem inflammatory syndrome in children (MIS-C) in the context of global SARS-CoV-2 pandemic. Circulation. 2020;142:429.
Metadata
Title
A young adult with COVID-19 and multisystem inflammatory syndrome in children (MIS-C)-like illness: a case report
Authors
Aaron D. Kofman
Emma K. Sizemore
Joshua F. Detelich
Benjamin Albrecht
Anne L. Piantadosi
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2020
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-020-05439-z

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