Multisystem Inflammatory Syndrome-Adult: A Rare Presentation of Infection by SARS-CoV-2
DOI:
https://doi.org/10.24950/rspmi.501Keywords:
COVID-19/complications, Exanthema, Heart Failure, SARS-CoV-2, Systemic Inflammatory Response SyndromeAbstract
Among the manifestations of COVID-19, we find multisystem inflammatory syndrome (MIS), characterized by a hyperinflammatory state in which multiorgan dysfunction occurs.
A 22-years-old woman came to the emergency department with dry cough, myalgias, rash and fever for 3 days. PCR for SARS-CoV-2 was positive. Admitted to hospital on day 5 of disease due to symptomatic worsening. She had lesions in erythematous-violaceous plaques on the trunk, thighs and back of the hands. On day 7 of disease, clinical worsening, so a computed tomography scan was performed revealing findings compatible with renal, splenic and hepatic hypoperfusion. Echocardiogram showed systolic dysfunction due to global hypocontractility (LVEF 25%-30%). MIS-A was admitted, with cutaneous, gastrointestinal and cardiac involvement. She was treated with human immunoglobulin, methylprednisolone and diuretics, with progressive clinical improvement and recovery of cardiac function.
Contrary to the more common severe forms of SARS-CoV-2 infection, in which pulmonary involvement prevails, in this syndrome the respiratory involvement is often mild, making it a diagnostic challenge.
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