A rare presentation of COVID-19 in a ten-year-old girl
Keywords:case report, COVID-19, Kawasaky Disease, multisystem inflammatory syndrome in children, SARS-CoV-2
Multisystem inflammatory syndrome in children (MIS-C) is a severe and rare manifestation of SARS-CoV-2 infection.
A 10-year-old-girl without epidemiological context of COVID-19 presented with fever, headache, and vomiting with two days of evolution. She was hemodynamically stable. Laboratory tests showed lymphopenia, mild thrombocytopenia, and positive C-reactive protein. Reverse transcription polymerase chain reaction (RT-PCR) for SARS-CoV-2 was negative. On the third day, she presented with worsening symptoms and non-pruriginous, non-petechial rash, with also worsening inflammatory parameters on laboratory assessment. The girl was admitted, and RT-PCR for SARS-CoV-2 was repeated, with positive result. On the fourth day, the patient was hypotensive, lethargic, and showed delayed capillary refill time, swelling and erythema of the palpebrae and nose, bilateral non-purulent conjunctivitis, reddened and cracked lips, strawberry tongue, and inflammation of mucous membranes. Multiorgan dysfunction developed, and she required admission to the Intensive Care Unit.
MIS-C is a severe and potentially fatal syndro me, which clinicians should be aware of in the present pandemic setting. Close cardiac follow-up is recommended.
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