Multisystem Inflammatory Syndrome in Children (MIS-C) with Kawasaki Disease (KD) phenotype – A case report

Abstract

The coronavirus pandemic has led to the emergence of a new entity in children called Multisystem Inflammatory Syndrome in Children (MIS-C), which has different phenotypes. Coronavirus disease 2019 (COVID-19) has affected all age groups, with the emergence of MIS-C, having features overlapping with Kawasaki Disease (KD). A case with a variant of MIS-C showing overlapping features of KD occurring in a child post-COVID infection is presented in this report.  A 2-year-old male was presented with complaints of fever and rash for the past 6 days. Examination showed maculopapular rash, conjunctival congestion, and unilateral cervical lymphadenopathy. Routine investigations were suggestive of thrombocytopenia, transaminitis, hyponatremia, and positive Creactive protein (CRP). The fever panel sent was negative. The patient was started on antibiotics provisionally.  But in view of the persisting fever and clinical assessment, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) IgG antibody and D dimer levels were elevated, which distinguished it from KD. The patient was diagnosed with a case of MIS-C with KD phenotype and managed accordingly. This case highlights that thorough clinical examination with necessary investigations helps in early diagnosis and timely treatment, since delay in diagnosis can lead to both short and long-term complications in MIS-C.