Old wine in new bottle

Abstract

For the last one and half years, COVID-19 pandemic has become a medical challenge all over the world. Patients fulfill criteria for Kawasaki disease in a substantial proportion of cases. MIS-C tends to occurr in previously healthy patients. MIS-C tends to affect black and Hispanic individuals. On the other hand Kawasaki disease tends to affect more of Asian population. The author reports a case of post COVID MIS-C in a 13 years child who presented with fever for 4 days and hypotension. Physical examination revealed left sided lymphadenopathy in neck, tachycardia and tachypnea. Investigations showed elevated CRP, ESR, D-dimer, PT-INR, ferritin, procalcitonin, very high antibody titer of SARS COV-2 IgG and low platelet count. Patient was treated with IV methylprednisolone, IV immunoglobulin, IV meropenem, SC enoxaparin and Tab aspirin. His condition gradually improved, BP normalised, and heart rate decreased and fever subsided. This case report emphasises that early recognition and concomitant treatment of COVID related MIS-C can enhance good outcome and negate potentially life threatening complications.