Case report: multisystem inflammatory syndrome associated with SARS-CoV-2 infection in pediatrics

Abstract

INTRODUCTION: The multisystemic inflammatory syndrome in pediatrics is a new entity with acute and severe presentation, which association with SARS-CoV-2 infection virus from COVID-19 has been questioned. The criteria to define a case of such syndrome were determined and published by Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO). One form of presentation of this entity is Kawasaki disease, either in the classic or incomplete forms, and/or associated with toxic shock. OBJECTIVES: Report a case of a SARS-CoV-2 seropositive patient, who developed Multisystemic Inflammatory Syndrome, Kawasaki-like disease. CASE REPORT: Preschooler, 4-years-old, male, arrives at the pediatric consultation with a history of 12-hours fever without other associated symptoms, but previously infected by SARS-CoV-2. On physical examination, he was feverish 38.3ºC, active, eupneic, with mild oropharyngeal hyperemia. In the subsequent 24 hours, fever persisted, and complaints of abdominal pain started, thus he was taken to a pediatric emergency room for diagnostic investigation. A worsening of the pain and significant reduction in activity were observed, with prostration, decreased food acceptance and diuresis. Four days after the onset of the fever, he developed signs of cardiac decompensation (shock), liver lowering, tachycardia with the presence of third sound, HR 186bpm, being taken to the pediatric ICU and a laboratory investigation was started to confirm a post-COVID-19 multisystemic inflammatory syndrome pediatric. CONCLUSION: Improving knowledge about the COVID-19 infection manifestations in children and its complications is necessary, since it is believed that there is a relationship between multisystemic inflammatory syndrome and SARS-CoV-2 infection in children.