Al Ameer Heba H, AlKadhem Sajjad M, Busaleh Fadi, AlKhwaitm Sami, Llaguno Maria Blesilda B
Infectious Diseases, Maternity and Children Hospital, Al-Ahsa, SAU.
Pediatrics, Maternity and Children Hospital, Al-Ahsa, SAU.
Cureus. 2020 Sep 22;12(9):e10589. doi: 10.7759/cureus.10589.
The World Health Organization is still revising the epidemiology of multi-system inflammatory syndrome in children (MIS-C) and the preliminary case definition, although there is a dearth of robust evidence regarding the clinical presentations, severity, and outcomes. Researchers, epidemiologists, and clinicians are struggling to characterize and describe the disease phenomenon while taking care of the diseased persons at the forefronts. This report tackles the first case of a 13-year-old Saudi female with the MIS-C mimicking Kawasaki disease. Her main manifestations were fever, gastrointestinal symptoms, evidence of organ failure with an increase in inflammatory markers, and a history of coronavirus disease (COVID-19) infection. She had glucose-6-phosphate dehydrogenase (G6PD) deficiency and no significant previous history of any disease. She presented with signs of acute illness: high-grade fever (39.6°C) for five days accompanied by sore throat, malaise, reduced oral intake, abdominal pain, diarrhea, skin rash, bilateral non-suppurative conjunctivitis, and erythematous, cracked lips. Eventually, she died despite aggressive management based on the Centers for Disease Control and Prevention and the Saudi Ministry of Health guidelines for COVID-19 management. Based on this case, we suggest that pediatricians need to be aware of such atypical presentations and early referral to tertiary care is imperative for further early diagnosis and management. MIS-C is a rare yet severe and highly critical complication of COVID-19 infection in pediatrics, leading to serious and life-threatening illnesses. Knowledge about the wide spectrum of presenting signs and symptoms and disease severity, including early detection and treatment, is pivotal to prevent a tragic outcome.
世界卫生组织仍在修订儿童多系统炎症综合征(MIS-C)的流行病学及初步病例定义,尽管关于其临床表现、严重程度和预后的有力证据匮乏。研究人员、流行病学家和临床医生在照顾处于前沿的患病儿童的同时,正努力对这种疾病现象进行特征描述。本报告讲述了首例疑似川崎病的13岁沙特女性MIS-C病例。她的主要表现为发热、胃肠道症状、伴有炎症标志物升高的器官功能衰竭迹象以及冠状病毒病(COVID-19)感染史。她患有葡萄糖-6-磷酸脱氢酶(G6PD)缺乏症,既往无任何重大疾病史。她出现急性病症状:高热(39.6°C)持续五天,伴有咽痛、全身不适、进食减少、腹痛、腹泻、皮疹、双侧非化脓性结膜炎以及嘴唇红肿皲裂。尽管依据美国疾病控制与预防中心及沙特卫生部的COVID-19管理指南进行了积极治疗,她最终还是去世了。基于该病例,我们建议儿科医生需警惕此类非典型表现,尽早转诊至三级医疗机构对于进一步的早期诊断和治疗至关重要。MIS-C是儿科COVID-19感染罕见但严重且极为关键的并发症,可导致严重及危及生命的疾病。了解广泛的症状体征及疾病严重程度,包括早期检测和治疗,对于预防悲剧结局至关重要。