Toxic shock-like syndrome and COVID-19: Multisystem inflammatory syndrome in children (MIS-C)
Toxic shock-like syndrome and COVID-19: Multisystem inflammatory syndrome in children (MIS-C)
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DOI：
10.1016/j.ajem.2020.05.117
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发表时间：
2020-11-01
影响因子：
3.6
通讯作者：
Sinert, Richard
中科院分区：
文献类型：
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作者：
Greene, Andrea G.;Saleh, Mona;Sinert, Richard
早期儿科人群中COVID-19的报告强调病程轻微，严重病例不成比例地影响婴儿和合并症儿科患者。4月底至5月初，在纽约市疫情达到高峰后，报告了与COVID-19相关的严重疾病病例，其中大多数是以前健康的5-19岁儿童。在SARS-CoV-2诊断检测阳性的情况下，这些病例中有许多表现为中毒性休克样综合征或川崎样综合征，疾病预防控制中心将这种表现称为多系统炎症综合征（MIS-C）。在医学界传播关于COVID-19严重和非典型表现的信息至关重要，因为事先了解可以帮助病例数量不断增加的社区做好准备，以便在急诊科迅速识别和治疗这些患者。我们描述了一名儿童的misc病例，他两次来到我们的急诊科（ED），第二次就诊时发现有与COVID-19相关的分布性休克、多器官损伤和全身性炎症的迹象。该病例描述了一名11岁的sars - cov -2阳性女性的两次急诊科就诊，她最初表现为发烧、皮疹和咽炎，并在48小时内出现心脏和肾脏功能障碍以及液体难治性低血压的证据，需要使用血管加压剂并入院PICU。(C) 2020由爱思唯尔公司出版
Early reports of COVID-19 in pediatric populations emphasized a mild course of disease with severe cases disproportionately affecting infant and comorbid pediatric patients. After the peak of the epidemic in New York City, in late April to early May, cases of severe illness associated with COVID-19 were reported among mostly previously healthy children ages 5-19. Many of these cases feature a toxic shock-like syndrome or Kawasaki-like syndrome in the setting of SARS-CoV-2 positive diagnostic testing and the CDC has termed this presentation Multisystem Inflammatory Syndrome (MIS-C). It is essential to disseminate information among the medical community regarding severe and atypical presentations of COVID-19 as prior knowledge can help communities with increasing caseloads prepare to quickly identify and treat these patients as they present in the emergency department. We describe a case of MIS-C in a child who presented to our Emergency Department (ED) twice and on the second visit was found to have signs of distributive shock, multi-organ injury and systemic inflammation associated with COVID-19. The case describes two ED visits by an 11year-old SARS-CoV-2-positive female who initially presented with fever, rash and pharyngitis and returned within 48 hours with evidence of cardiac and renal dysfunction and fluid-refractory hypotension requiring vasopressors and PICU admission. (C) 2020 Published by Elsevier Inc.Y