Kawasaki-like Syndrome as an Emerging Complication of SARS-CoV-2 Infection in Young Adults
  • César Burgi Vieira
    Unidade Funcional Medicina 2.4, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal http://orcid.org/0000-0003-3616-5440
  • Ana Teresa Ferreira
    Unidade Funcional Medicina 4, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
  • Filipa Botelho Cardoso
    Unidade Funcional Medicina 1.4, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
  • Jorge Pelicano Paulos
    Departamento de Anestesiologia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
  • Nuno Germano
    Unidade de Cuidados Intensivos Polivalente 7, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal

Keywords

COVID-19, Kawasaki syndrome, vasculitis, adult, multisystem inflammatory syndrome

Abstract

Background: Kawasaki-like syndrome occurring in children during the COVID-19 pandemic has been labelled multisystem inflammatory syndrome in children (MIS-C) by the CDC and paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 infection (PIMS-TS) by the ECDC. 
Case report: We report the case of an 18-year-old male patient presenting with a 72-hour history of abdominal pain, fever, erythematous skin rash, vomiting and diarrhoea. Examination showed he also had shock and he was first thought to have oedematous cholecystitis. SARS-CoV-2 infection was also diagnosed. He was admitted to the ICU, and echocardiography showed cardiac dysfunction, with a low ejection fraction and low cardiac index. High-sensitivity troponin serum levels were elevated. The patient received inotropic and vasopressor support. As he fulfilled several criteria for MIS-C/PIMS-TS, he was administered acetylsalicylic acid, corticosteroids and immunoglobulin, with a good clinical response.<br />
Conclusion: This case emphasizes how this severe presentation of COVID-19 can easily be misdiagnosed if the clinician is less aware of this syndrome in younger patients.

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    Published: 2020-09-10
    Issue: 2020: Vol 7 No 10 (view)

    How to cite:
    1.
    Vieira CB, Ferreira AT, Cardoso FB, Paulos JP, Germano N. Kawasaki-like Syndrome as an Emerging Complication of SARS-CoV-2 Infection in Young Adults. EJCRIM 2020;7 doi:10.12890/2020_001886.

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