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Kawasaki-like Syndrome as an Emerging Complication of SARS-CoV-2 Infection in Young Adults

Authors
  • Burgi Vieira, César1
  • Ferreira, Ana Teresa2
  • Botelho Cardoso, Filipa3
  • Pelicano Paulos, Jorge4
  • Germano, Nuno5
  • 1 Unidade Funcional Medicina 2.4, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
  • 2 Unidade Funcional Medicina 4, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
  • 3 Unidade Funcional Medicina 1.4, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
  • 4 Departamento de Anestesiologia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
  • 5 Unidade de Cuidados Intensivos Polivalente 7, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
Type
Published Article
Journal
European Journal of Case Reports in Internal Medicine
Publisher
SMC Media Srl
Publication Date
Sep 10, 2020
Volume
7
Issue
10
Identifiers
DOI: 10.12890/2020_001886
PMID: 33083367
PMCID: PMC7546551
Source
PubMed Central
Keywords
License
Unknown

Abstract

Background Kawasaki-like syndrome occurring in children during the COVID-19 pandemic has been labelled multisystem inflammatory syndrome in children (MIS-C) by the CDC and paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 infection (PIMS-TS) by the ECDC. Case report We report the case of an 18-year-old male patient presenting with a 72-hour history of abdominal pain, fever, erythematous skin rash, vomiting and diarrhoea. Examination showed he also had shock and he was first thought to have oedematous cholecystitis. SARS-CoV-2 infection was also diagnosed. He was admitted to the ICU, and echocardiography showed cardiac dysfunction, with a low ejection fraction and low cardiac index. High-sensitivity troponin serum levels were elevated. The patient received inotropic and vasopressor support. As he fulfilled several criteria for MIS-C/PIMS-TS, he was administered acetylsalicylic acid, corticosteroids and immunoglobulin, with a good clinical response. Conclusion This case emphasizes how this severe presentation of COVID-19 can easily be misdiagnosed if the clinician is less aware of this syndrome in younger patients. LEARNING POINTS SARS-CoV-2 infection is a diagnostic challenge in some patients with atypical clinical presentations, who may have MIS-C/PIMS-TS. Physicians should be aware of this condition when evaluating teenagers and young adults with COVID-19.

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