You are here

Article Text

Article menu
Download PDFPDF
Case report
Multisystem inflammatory syndrome in a neonate masquerading as surgical abdomen
  1. Gopal Agrawal1,
  2. Sanjay Wazir1,
  3. Ajay Arora1 and
  4. Sidharth Kumar Sethi1,2
  1. 1Department of Pediatrics and Neonatology, Cloudnine Hospital, Gurgaon, Haryana, India
  2. 2Department of Pediatric Nephrology, Medanta The Medicity, Gurgaon, Haryana, India
  1. Correspondence to Dr Sidharth Kumar Sethi; sidsdoc{at}gmail.com

Abstract

Worldwide, thousands of cases of multisystem inflammatory syndrome in children (MIS-C) have already been reported in children. Evidence regarding neonatal MIS-C is limited. We present the first case report of a neonate presenting within 48 hours of life with predominant abdominal signs mimicking surgical abdomen. Clinical picture comprised fever, multiorgan dysfunction (gastrointestinal, cardiorespiratory, hepatic and dermatological), positive inflammatory markers, high ferritin and high D-dimer levels. Cardiac enzyme N-terminal-pro-B-type natriuretic peptide as well as D-dimer levels were elevated. Blood, urine, stool and cerebrospinal fluid cultures were sterile. Positive anti-SARS-CoV-2 IgG in both the mother and the infant, along with an epidemiological evidence of maternal contact with COVID-19, clinched the diagnosis of MIS-C. Immunomodulatory drugs (intravenous immunoglobulin and systemic steroids) were administered and showed good clinical response. A high index of suspicion of MIS-C in critically ill neonates can improve outcomes.

  • COVID-19
  • dermatology
  • infectious diseases
  • neonatal and paediatric intensive care

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/bcr-2021-246579

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Contributors GA and SW: involved in clinical care of the patient, supervised data collection, conceived and wrote the initial draft, and reviewed and finalised the final manuscript. AA and SKS: involved in clinical care of the patient, co-ordinated the data collection and critically reviewed the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agreed to be accountable for all aspects of the work.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.