Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal.
Department of Pediatrics, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal.
JNMA J Nepal Med Assoc. 2022 Nov 2;60(255):965-968. doi: 10.31729/jnma.6376.
Children with Coronavirus disease 2019 infection usually have mild symptoms but rarely may present with a life-threatening condition called a multisystem inflammatory syndrome. We report a case of COVID-19-related multisystem inflammatory syndrome in an 8-year-old boy who presented with cardiogenic shock due to acute myocarditis with no features of Kawasaki disease. Cardiogenic shock was refractory to fluids and inotropes. Later, this case was successfully managed with hydrocortisone and intravenous immunoglobulin. Therefore, this case report highlights keeping a lookout for such atypical presentations and early referral to a higher center for timely intervention and aggressive therapy specifically directed against the underlying inflammatory process to ameliorate the outcomes.
cardiogenic shock; COVID-19; kawasaki disease; myocarditis; Nepal.
患有 2019 年冠状病毒病的儿童通常症状较轻,但极少数可能出现一种称为多系统炎症综合征的危及生命的病症。我们报告了一例 8 岁男孩的 COVID-19 相关多系统炎症综合征病例,该病例因急性心肌炎引起的心源性休克,没有川崎病的特征。心源性休克对液体和正性肌力药物无反应。后来,该病例成功地用氢化可的松和静脉注射免疫球蛋白治疗。因此,本病例报告强调要注意这种非典型表现,并尽早转至上级中心,以便及时进行干预和针对潜在炎症过程的积极治疗,从而改善预后。
心源性休克;COVID-19;川崎病;心肌炎;尼泊尔。