A Case of ‘Multi-Inflammatory Syndrome in Children’ Complicated with Cardiogenic Shock

Nazmiye Serap Biçer; Zeynep Türe; Birkan  Ülger; Aliye Esmaoğlu

doi:10.58600/eurjther-28-4-0074

Authors

Nazmiye Serap Biçer Erciyes University, Faculty of Medicine, Department of Internal Medicine, Kayseri, Turkey https://orcid.org/0000-0001-8762-2571
Zeynep Türe Erciyes University, Faculty of Medicine, Department of Infectious Diseases, Kayseri, Turkey https://orcid.org/0000-0001-6895-0318
Birkan Ülger Erciyes University, Faculty of Medicine, Department of Anesthesiology and Reanimation, Kayseri, Turkey https://orcid.org/0000-0002-7737-2553
Aliye Esmaoğlu Erciyes University, Faculty of Medicine, Department of Anesthesiology and Reanimation, Kayseri, Turkey https://orcid.org/0000-0002-8267-138X

DOI:

https://doi.org/10.58600/eurjther-28-4-0074

Keywords:

COVID 19, MIS-C, SARS-CoV 2, Cardiogenic Shock

Abstract

SARS Cov-2 infection causes Multi-Inflammatory Syndrome in Children (MIS-C), a serious condition that affects children. We report an 18-year-old Turkish male who was diagnosed with MIS-C and successfully treated. He was diagnosed with MIS-C and required invasive mechanical ventilation due to cardiogenic shock, after what he recovered. With a high temperature, rash, and conjunctival hyperemia, the patient was taken to the emergency department. He had no symptomatic COVID-19 in his medical history, although he had had contact with a COVID-19 positive patient in the near past. Physical examination revealed an erythematous maculopapular rash on the back and neck, as well as hepatosplenomegaly. SARS-CoV-2 IgM and IgG positivity were detected in the rapid antibody test. Following the procedure, rectal bleeding and tachypnea developed. Inflammation indicators and pro-BNP levels both increased. With echocardiogenic examination, the ejection fraction decreased from 50-55 percent to 35%. He needed invasive mechanical ventilation. As a result, the case was classified as MIS-C with predominant cardiac and gastrointestinal involvement. The patient was discharged after a successful multidisciplinary approach. Although COVID-19 infection in children and adolescents is asymptomatic or minimally symptomatic, clinicians should be aware of post-infection autoimmune complications.

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