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Boletín Clínico de la Asociación Médica del Hospital Infantil del Estado de Sonora

2022, Number 1

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Bol Clin Hosp Infant Edo Son 2022; 39 (1)

Kawasaki disease and pediatric multi-system inflammatory syndrome by SARS-COV-2: A case report

Santamaría-Arza C, Gónzalez-Ortiz AM, Reyes-Gómez U, Reyes-Hernández KL, Aguilar-Figueroa ÉS, Alonso-PérezNC, Quero-Hernández A, Baeza-Casillas JA, Reyes-Hernández MU, Quero-Estrada A, Miguel-Reyes A, López-Cruz G, Aguilar-Román AB, Pineda-Gordillo A

Language: Spanish
References: 13
Page: 51-57
PDF size: 252.82 Kb.


ABSTRACT

Pediatric multisystemic inflammatory syndrome (PIMS-C) associated with COVID-19 is an entity that represents 2.1% of cases in children. 6 criteria are required for its diagnosis. This clinical case presents 16-year-old female, starts with a frontal, oppressive headache, intensity 6/10 and photophobia; dry cough, 4-5 fever peaks a day with a maximum temperature of 39.7 degrees. Attack on general condition, breathless cough, cyanosis, saturation 84% and minor effort 74%, nausea, vomiting 3-4 in 24 hours, hypothermia integrating diagnosis of atypical pneumonia is added. The Film array respiratory panel is reported negative, including SARS-CoV-2. Chest CT showed bibasal pulmonary infiltrates associated with subsegmental atelectasis and discrete “ground glass” with air bronchogram, pericardial and pleural effusion. Cardiac magnetic resonance imaging shows pericarditis, mild pericardial effusion, LVEF 63%, FEVD 50%, mild mitral and tricuspid regurgitation. Presented hypotension 64/55, without adequate chronotropic response, so a load of Hartman solution and albumin. Due to neurological, cardiac, pulmonary, hepatic and elevated inflammatory and hematological parameters, the diagnosis of multisystemic inflammatory syndrome is integrated associated with COVID 19, with pharmacological treatment is set which improvement was seen clinic and decrease of inflammatory markers. The case presented below is a PIMS manifested as complete Kawasaki-like disease associated with SARS-CoV-2 infection.


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