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Toxic shock-like syndrome and COVID-19: A case report of multisystem inflammatory syndrome in children (MIS-C).
Am J Emerg Med. 2020 Jun 06 [Online ahead of print]AJ

Abstract

Early reports of COVID-19 in pediatric populations emphasized a mild course of disease with severe cases disproportionately affecting infant and comorbid pediatric patients. After the peak of the epidemic in New York City, in late April to early May, cases of severe illness associated with COVID-19 were reported among mostly previously healthy children ages 5-19. Many of these cases feature a toxic shock-like syndrome or Kawasaki-like syndrome in the setting of SARS-CoV-2 positive diagnostic testing and the CDC has termed this presentation Multisystem Inflammatory Syndrome (MIS-C). It is essential to disseminate information among the medical community regarding severe and atypical presentations of COVID-19 as prior knowledge can help communities with increasing caseloads prepare to quickly identify and treat these patients as they present in the emergency department. We describe a case of MIS-C in a child who presented to our Emergency Department (ED) twice and on the second visit was found to have signs of distributive shock, multi-organ injury and systemic inflammation associated with COVID-19. The case describes two ED visits by an 11- year-old SARS-CoV-2-positive female who initially presented with fever, rash and pharyngitis and returned within 48 hours with evidence of cardiac and renal dysfunction and fluid-refractory hypotension requiring vasopressors and PICU admission.

Authors+Show Affiliations

SUNY Downstate Health Sciences University, 450 Clarkson Ave., Brooklyn, NY 11203, USA. Electronic address: andrea.greene@downstate.edu.SUNY Downstate Health Sciences University, 450 Clarkson Ave., Brooklyn, NY 11203, USA. Electronic address: salehm3@nychhc.org.SUNY Downstate Health Sciences University, 450 Clarkson Ave., Brooklyn, NY 11203, USA.SUNY Downstate Health Sciences University, 450 Clarkson Ave., Brooklyn, NY 11203, USA.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

32532619

Citation

Greene, Andrea G., et al. "Toxic Shock-like Syndrome and COVID-19: a Case Report of Multisystem Inflammatory Syndrome in Children (MIS-C)." The American Journal of Emergency Medicine, 2020.
Greene AG, Saleh M, Roseman E, et al. Toxic shock-like syndrome and COVID-19: A case report of multisystem inflammatory syndrome in children (MIS-C). Am J Emerg Med. 2020.
Greene, A. G., Saleh, M., Roseman, E., & Sinert, R. (2020). Toxic shock-like syndrome and COVID-19: A case report of multisystem inflammatory syndrome in children (MIS-C). The American Journal of Emergency Medicine. https://doi.org/10.1016/j.ajem.2020.05.117
Greene AG, et al. Toxic Shock-like Syndrome and COVID-19: a Case Report of Multisystem Inflammatory Syndrome in Children (MIS-C). Am J Emerg Med. 2020 Jun 6; PubMed PMID: 32532619.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Toxic shock-like syndrome and COVID-19: A case report of multisystem inflammatory syndrome in children (MIS-C). AU - Greene,Andrea G, AU - Saleh,Mona, AU - Roseman,Eric, AU - Sinert,Richard, Y1 - 2020/06/06/ PY - 2020/05/26/received PY - 2020/05/31/accepted PY - 2020/6/14/entrez PY - 2020/6/14/pubmed PY - 2020/6/14/medline KW - COVID-19 KW - Child KW - Coronavirus KW - Enoxaparin KW - Pediatric KW - Remdesivir KW - Septic KW - Shock KW - Tocilizumab JF - The American journal of emergency medicine JO - Am J Emerg Med N2 - Early reports of COVID-19 in pediatric populations emphasized a mild course of disease with severe cases disproportionately affecting infant and comorbid pediatric patients. After the peak of the epidemic in New York City, in late April to early May, cases of severe illness associated with COVID-19 were reported among mostly previously healthy children ages 5-19. Many of these cases feature a toxic shock-like syndrome or Kawasaki-like syndrome in the setting of SARS-CoV-2 positive diagnostic testing and the CDC has termed this presentation Multisystem Inflammatory Syndrome (MIS-C). It is essential to disseminate information among the medical community regarding severe and atypical presentations of COVID-19 as prior knowledge can help communities with increasing caseloads prepare to quickly identify and treat these patients as they present in the emergency department. We describe a case of MIS-C in a child who presented to our Emergency Department (ED) twice and on the second visit was found to have signs of distributive shock, multi-organ injury and systemic inflammation associated with COVID-19. The case describes two ED visits by an 11- year-old SARS-CoV-2-positive female who initially presented with fever, rash and pharyngitis and returned within 48 hours with evidence of cardiac and renal dysfunction and fluid-refractory hypotension requiring vasopressors and PICU admission. SN - 1532-8171 UR - https://www.unboundmedicine.com/medline/citation/32532619/Toxic_shock_like_syndrome_and_COVID_19:_A_case_report_of_multisystem_inflammatory_syndrome_in_children__MIS_C__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-6757(20)30492-7 DB - PRIME DP - Unbound Medicine ER -
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