article · Pan African Medical Journal
Multisystem inflammatory syndrome in children associated with COVID-19, known as MIS-C, is a rare condition that requires high clinical suspicion to identify promptly. In this reported case, a child initially presented with signs resembling acute gastroenteritis. Despite receiving antibiotic treatment during hospitalisation, the patient deteriorated clinically, showing deranged laboratory results and notable radiological findings. Echocardiography identified acute myocarditis with myocardial dysfunction, accompanied by elevated cardiac enzymes, despite an initially normal preliminary echocardiogram. Treatment involved intravenous human immunoglobulin, but subsequent decline required an escalation of therapy to include methylprednisolone and the inotrope norepinephrine. Timely recognition and swift escalation of clinical interventions following initial immunoglobulin administration are critical to avoid severe complications and mortality.
MIS-C can masquerade as common illnesses such as gastroenteritis, leading to delayed diagnoses. Understanding that a child can rapidly develop life-threatening heart complications, even after a normal initial scan, underscores the importance of urgent escalation pathways and close monitoring in paediatric COVID-19 complications.
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Given the rarity of multisystem inflammatory syndrome related to COVID-19 (MIS-C). This case report highlights the high index of suspicion to diagnose MIS-C in a child who presented with symptoms suggestive of acute gastroenteritis. While admitted in the hospital, she deteriorated with worsening of symptoms, clinical decline, deranged laboratory markers, and significant radiological findings, even though on antibiotics. She had acute myocarditis with myocardial dysfunction on echocardiography and raised cardiac enzymes. Intravenous human immunoglobulin (IVIG) was given, but there was additional need for inotrope (norepinephrine) and methylprednisolone albeit the preliminary echocardiogram was normal. Early recognition of MIS-C with rapid escalation of care post IVIG administration is needed to prevent morbidity and mortality.
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DOI: 10.11604/pamj.2025.51.96.40535
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