Somasetia Dadang Hudaya, Malahayati Tri Tunggal, Andriyani Fina Meilyana, Setiabudi Djatnika, Nataprawira Heda Melinda
Department of Child Health, Hasan Sadikin General Hospital, Faculty of Medicine, Universitas Padjadjaran, Indonesia.
IDCases. 2020;22:e01002. doi: 10.1016/j.idcr.2020.e01002. Epub 2020 Nov 2.
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or corona virus disease 2019 (COVID-19) is a currently ongoing global pandemic. Children tend to show milder symptoms of infection compared to adults. Concurrently, in April 2020, there was reported an escalation of Kawasaki cases like disease in children treated in the intensive care unit and showing polymerase chain reaction (PCR) SARS CoV-2 positive. Those children had a hyperinflammatory response, which caused the failure of multi-organ and shock. Several countries have reported similar cases since then. Here we describe a case of a patient with COVID-19 and concurrent dengue infection presenting MIS-C. A 6-year-old male with no past medical history looked pale with fatigue and brought to an emergency room from a referral hospital. The patient presented with fever, acute abdominal pain, shock, and deteriorate quickly, confirmed with the serology of SARS CoV-2 IgM was reactive, serology of anti-dengue IgM was reactive and PCR SARS CoV-2 was negative. Possibly it is MIS-C coinfection with severe unusual dengue infection or MIS-C with false-positive dengue serologic test leading to a fatal outcome.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）或2019冠状病毒病（COVID-19）是目前正在全球范围内流行的疫情。与成人相比，儿童感染后的症状往往较轻。同时，2020年4月有报告称，在重症监护病房接受治疗且聚合酶链反应（PCR）检测SARS-CoV-2呈阳性的儿童中，川崎病样疾病的病例有所增加。这些儿童出现了过度炎症反应，导致多器官功能衰竭和休克。从那时起，几个国家都报告了类似病例。在此，我们描述一例患有COVID-19并同时感染登革热的患者出现儿童多系统炎症综合征（MIS-C）的病例。一名6岁男性，无既往病史，面色苍白、疲倦，从转诊医院被送往急诊室。患者出现发热、急性腹痛、休克，且病情迅速恶化，SARS-CoV-2 IgM血清学检测呈阳性，抗登革热IgM血清学检测呈阳性，而PCR检测SARS-CoV-2呈阴性。这可能是MIS-C合并严重罕见的登革热感染，或者是MIS-C合并登革热血清学检测假阳性，导致了致命后果。
