Department of Infectious Diseases, Cork University Hospital Group, Cork, Ireland.
Microbiology, Cork University Hospital, Cork, Ireland.
BMJ Case Rep. 2021 Jul 23;14(7):e240845. doi: 10.1136/bcr-2020-240845.
Kawasaki-like hyperinflammatory syndrome has been widely described as a manifestation of SARS-CoV-2 infection in paediatric patients. We report a compatible presentation and suggest that physicians consider the potential for this multisystem inflammatory syndrome to occur in adults. A 23-year-old man presented to hospital with a 4-day history of vomiting, diarrhoea, dry cough, fever and a blanching erythematous rash on hands, feet and buttocks. He was otherwise fit and healthy. On day 3 of admission, marked bilateral conjunctivitis developed and high sensitivity troponin I increased significantly, followed by acute respiratory compromise requiring high-flow nasal oxygen therapy. Transthoracic echocardiogram on day 5 showed severe global hypokinesis of the left ventricle with an ejection fraction of 22%. SARS-CoV-2 was not detected by reverse transcription PCR on nasopharyngeal swabs, sputum or stool samples, however, SARS-CoV-2 antibody was positive. The patient's syndrome resolved and cardiomyopathy reversed completely with supportive measures. He has since made a good recovery.
川崎样超敏性炎症综合征已被广泛描述为 SARS-CoV-2 感染在儿科患者中的一种表现。我们报告了一个符合该病表现的病例，并建议医生考虑这种多系统炎症综合征在成人中发生的可能性。一名 23 岁男性因呕吐、腹泻、干咳、发热和手掌、足底及臀部红斑疹 4 天就诊。他既往健康。入院第 3 天，出现明显双侧结膜炎和高敏肌钙蛋白 I 显著升高，随后出现急性呼吸窘迫，需要高流量鼻氧疗。入院第 5 天的经胸超声心动图显示左心室严重节段性运动障碍，射血分数为 22%。鼻咽拭子、痰或粪便样本的逆转录 PCR 未检测到 SARS-CoV-2，但 SARS-CoV-2 抗体阳性。患者的综合征通过支持性治疗得到缓解，心肌病完全逆转。此后，他恢复良好。
