Multisystem Inflammatory Syndrome in Children [MIS-C] - A case report

Abstract

After the appearance of COVID 19 infection, surging number of nations reported children with inflammatory syndrome, presented with clinical features that overlaps with Kawasaki disease, Toxic shock syndrome, Macrophage Activation Syndrome. Intravenous immunoglobulin with or without steroid or aspirin is the preferred management for MIS-C. Here we report a case of 6-y-old girl who was managed by intravenous steroids alone. On examination, the child had bilateral Conjunctival congestion with persisting high grade fever. Initial investigations exhibited elevated inflammatory parameters such as ESR and CRP. Echocardiography displayed grade 2 Mitral regurgitation and grade 2-3 tricuspid regurgitation with mild PAH. Cardiac isoenzymes CK-MB was also elevated, suggesting myocardial cell wall injury. She was treated with antibiotics, steroids and antipyretic. RT PCR for SARS-CoV-2 was negative but antibody test was positive. Her clinical condition improved and became afebrile from day 5, inflammatory parameters were decreased and was discharged after 11 days of hospital stay.