Is It Stevens–Johnson Syndrome or MIS-C with Mucocutaneous Involvement?

Abstract

Background. Severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) can be present in the form of multisystem inflammatory disease in children. Case Presentation. A 25-month-old boy presented with fever, malaise, diffuse maculopapular rashes, and mucosal involvement during the COVID-19 pandemic. He was first diagnosed with Stevens–Johnson syndrome (SJS). Further evaluation revealed lymphopenia, thrombocytopenia, and elevated levels of C-reactive protein (CRP), ferritin, and fibrinogen. This was followed by a positive polymerase chain reaction (PCR) test for COVID-19. In addition to receiving initial care for SJS, he was treated for MIS-C, which led to his recovery after four days. Conclusion. COVID-19 infection should be considered in children with fever and dermatological features during the pandemic because it may cause different features of the multisystem inflammatory syndrome in children (MIS-C), suggestive of delayed hyperimmune response.

Complete Remission in a Child With Multisystem Inflammatory Syndrome and Stevens-Johnson Syndrome Treated With Infliximab

“…Despite this, they deteriorated, required venovenous extracorporeal exchange, and unfortunately died [ 2 ]. Karimi A et al described a 25-month-old boy with fever and maculopapular rash that started in the feet and then generalized, progressed to bullae, and became ulcerated [ 3 ]. He had contact with his mother, who had an upper respiratory tract infection, three weeks prior to becoming symptomatic, and his COVID-19 PCR test result was positive.…”

“…The cutaneous manifestations of MIS-C are variable, with very few cases describing Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) as a presenting feature. Katlan B et al and Karimi A et al described three patients with MIS-C and SJS [ 2 , 3 ]. Despite intensive treatment, the two patients described by Katlan B et al died [ 2 ].…”

Pediatric Stevens–Johnson syndrome associated with severe acute respiratory syndrome coronavirus 2 infection

“…Multisystem inflammatory syndrome in children (MIS‐C) and Kawasaki disease can develop after severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection 1 . There have been several cases of SJS reported in adults after SARS‐CoV‐2 infection, 2 but few cases have been reported in children 3,4 . We experienced a pediatric case of SJS during SARS‐CoV‐2 infection and report that differentiating SJS from MIS‐C or Kawasaki disease was important.…”

“…1 There have been several cases of SJS reported in adults after SARS-CoV-2 infection, 2 but few cases have been reported in children. 3,4 We experienced a pediatric case of SJS during SARS-CoV-2 infection and report that differentiating SJS from MIS-C or Kawasaki disease was important.…”

“…Various infectious agents, including Mycoplasma pneumoniae, are associated with SJS in children, 5 but there have been few reports of SJS associated with COVID-19 -only two detailed cases of SJS/TEN complicated by COVID-19 in children have been reported to date. 2,3 In previous reports, patients were treated with corticosteroids, immunoglobulin, and cyclosporine. In all cases, treatment was successful and no sequelae were observed.…”