A Fatal Case of Multisystem Inflammatory Syndrome in Adult (MIS-A) in a Post Covid-19 Patient
Keywords:
COVID-19, fever, inflammatory markers, MIS-A, acalculous cholecystitis
Abstract
Multisystem Inflammatory Syndrome (MIS-A) is a hyperinflammatory condition occurring in adults with age >21 years. It is a rarely reported, potentially lethal condition observed in COVID-19 infections. We report a case of a 31-year-old young male with a history of COVID-19 infection one month prior, who presented with fever, abdominal pain, nausea and recurrent vomiting for 3 days and was eventually diagnosed with MIS-A. In adults presenting with raised inflammatory markers and multisystem involvement in a post COVID-19 infection, a high index of suspicion is required for diagnosis and prompt initiation of treatment with corticosteroids and IVIG is required for improved outcome.
References
1. Multisystem Inflammatory Syndrome (MIS) [Internet]. Centers for Disease Control and Prevention. 2021 [cited 10 July 2021]. Available from:https://www.cdc.gov/mis-a/hcp. html
2. Morris S, Schwartz N, Patel P, Abbo L, Beauchamps L, Balan S. Case Series of Multisystem Inflammatory Syndrome in Adults Associated with SARS-CoV-2 Infection– United Kingdom and United States. MMWR Morbidity and Mortality Weekly Report.2020;69(40):1450-1456.
3. Baruah R, Gupta R. Case Report on a Young Patient with Multisystem Inflammatory Syndrome in Adult (MIS-A).
Ann Med Health Sci Res. 2021;11(4):1385-1387.
4. Dabas R, Varadaraj G, Sandhu S, Bhatnagar A, Pal R. Kawasaki-like multisystem inflammatory syndrome associated
with COVID-19 in an adult: a case report. Br J Dermatol. 2021 Oct;185(4):859-861.
5. Chau VQ, Giustino G, Mahmood K, Oliveros E, Neibart E, Oloomi M, Moss N, Mitter SS, Contreras JP, Croft L, Serrao G, Parikh AG, Lala A, Trivieri MG, LaRocca G, Anyanwu A, Pinney SP, Mancini DM. Cardiogenic Shock and Hyperinflammatory Syndrome in Young Males With COVID-19. Circ Heart Fail. 2020 Oct;13(10):e007485.
6. Oxley TJ, Mocco J, Majidi S, Kellner CP, Shoirah H, Singh IP, De Leacy RA, Shigematsu T, Ladner TR, Yaeger KA, Skliut M, Weinberger J, Dangayach NS, Bederson JB, Tuhrim S, Fifi JT. Large-Vessel Stroke as a Presenting Feature of Covid-19 in the Young. N Engl J Med. 2020 May 14;382(20):e60.
7. Dove ML, Jaggi P, Kelleman M, Abuali M, Ang JY, Ballan W, Basu SK, Campbell MJ, Chikkabyrappa SM, Choueiter NF, Clouser KN, Corwin D, Edwards A, Gertz SJ, Ghassemzadeh R, Jarrah RJ, Katz SE, Knutson SM, Kuebler JD, Lighter J, Mikesell C, Mongkolrattanothai K, Morton T, Nakra NA, Olivero R, Osborne CM, Panesar LE, Parsons S, Patel RM, Schuette J, Thacker D, Tremoulet AH, Vidwan NK, Oster ME. Multisystem Inflammatory Syndrome in Children: Survey of Protocols for Early Hospital Evaluation and Management. J Pediatr. 2021 Feb;229:33-40.
2. Morris S, Schwartz N, Patel P, Abbo L, Beauchamps L, Balan S. Case Series of Multisystem Inflammatory Syndrome in Adults Associated with SARS-CoV-2 Infection– United Kingdom and United States. MMWR Morbidity and Mortality Weekly Report.2020;69(40):1450-1456.
3. Baruah R, Gupta R. Case Report on a Young Patient with Multisystem Inflammatory Syndrome in Adult (MIS-A).
Ann Med Health Sci Res. 2021;11(4):1385-1387.
4. Dabas R, Varadaraj G, Sandhu S, Bhatnagar A, Pal R. Kawasaki-like multisystem inflammatory syndrome associated
with COVID-19 in an adult: a case report. Br J Dermatol. 2021 Oct;185(4):859-861.
5. Chau VQ, Giustino G, Mahmood K, Oliveros E, Neibart E, Oloomi M, Moss N, Mitter SS, Contreras JP, Croft L, Serrao G, Parikh AG, Lala A, Trivieri MG, LaRocca G, Anyanwu A, Pinney SP, Mancini DM. Cardiogenic Shock and Hyperinflammatory Syndrome in Young Males With COVID-19. Circ Heart Fail. 2020 Oct;13(10):e007485.
6. Oxley TJ, Mocco J, Majidi S, Kellner CP, Shoirah H, Singh IP, De Leacy RA, Shigematsu T, Ladner TR, Yaeger KA, Skliut M, Weinberger J, Dangayach NS, Bederson JB, Tuhrim S, Fifi JT. Large-Vessel Stroke as a Presenting Feature of Covid-19 in the Young. N Engl J Med. 2020 May 14;382(20):e60.
7. Dove ML, Jaggi P, Kelleman M, Abuali M, Ang JY, Ballan W, Basu SK, Campbell MJ, Chikkabyrappa SM, Choueiter NF, Clouser KN, Corwin D, Edwards A, Gertz SJ, Ghassemzadeh R, Jarrah RJ, Katz SE, Knutson SM, Kuebler JD, Lighter J, Mikesell C, Mongkolrattanothai K, Morton T, Nakra NA, Olivero R, Osborne CM, Panesar LE, Parsons S, Patel RM, Schuette J, Thacker D, Tremoulet AH, Vidwan NK, Oster ME. Multisystem Inflammatory Syndrome in Children: Survey of Protocols for Early Hospital Evaluation and Management. J Pediatr. 2021 Feb;229:33-40.
Published
2022-01-31
How to Cite
Dr. Saurabh Puri, Dr. Ashok Kumar Grover, Dr. Pankaj Nand Choudhary, Dr. Shashwat Saurabh, Dr. Arjun Prem Gupta. (2022). A Fatal Case of Multisystem Inflammatory Syndrome in Adult (MIS-A) in a Post Covid-19 Patient. The Indian Practitioner, 75(1), 41-43. Retrieved from https://articles.theindianpractitioner.com/index.php/tip/article/view/1302
Section
Case Reports
