A Multisystem Inflammatory Syndrome in Children in Manipur

Most of the children infected with Covid-19 have mild symptoms or are vastly asymptomatic. But a serious condition that occur in children infected with Covid-19 after being asymptomatic or mildly symptomatic is called Multisystem Inflammatory Syndrome (MIS-C). In this clinical entity, children developing Multisystem Inflammatory Syndrome in Children (MIS- C) have multiple organ or tissue involvement. They can have heart involvement that can lead to failure. Lung, kidneys, gut, blood vessels, skin, eyes and brain can get involved too. Common signs are fever, headache more than 24 hrs, vomiting, diarrhea, pain abdomen, skin rashes, profound tiredness, rapid breathing, red eyes, lymphnode enlargement and redness of tongue and lips.. These signs can easily be fitting to many childhood diseases such as Kawasaki Disease or Acute pyomenigitis.
We had a 10 yr old boy admitted at Mother’s Care Children Hospital and Research Centre having this disease who had fever for 5 days, severe headache, profound weakness, severe pain abdomen. He also had neck rigidity. His Covid-19 RTPCR Test was negative at admission. He developed rashes, redness of eyes, red lips and tongue along with lymphnode enlargement in the neck. His (LVEF) left heart function was depressed and went to shock. He was managed in our Pediatric Intensive Care Unit, needing multiple support .Suspecting Multisystem Inflammatory Syndrome in Children (MIS-C). His antibody test was sent for Covid-19 and was reported to be positive. He was discharged well yesterday.
This is the first case of Multisystem Inflammatory Syndrome in Children (MIS-C), a post Covid-19 complication, which a life is threatening that we have encountered. We are posting this write up as we believe parents as well as caregivers need to have high suspicion of this entity at the backdrop of the pandemic. Many children may have been infected without symptom but may develop this disease later. Early and optimum intervention will be of utmost importance for favorable outcome in our children.
Submitted by Management
Mother’s Care Children Hospital and Research Centre
Sagolband Moirang Leirak, Imphal West