Adult Inflammatory Multi-System Syndrome Mimicking Kawasaki Disease in a Patient With COVID-19

Boniface Malangu,Javier A Quintero,Eugenio M Capitle

doi:10.7759/cureus.11750

Abstract

We describe a 46-year-old male with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who presented as a Kawasaki-like syndrome with features including prolonged fever, bilateral conjunctivitis, oral mucosal swelling, diffuse erythematous rash, cervical and hilar lymphadenopathy, as well as cardiovascular complications and multi-organ failure. There are several reports of a similar clinical entity mimicking Kawasaki disease (KD) in the pediatric population, which has been termed Pediatric Inflammatory Multisystem Syndrome Temporally Associated with SARS-CoV-2 (PIMS-TS) by the Royal College of Pediatric and Child Health. To our knowledge, to date, there has been only one case report of COVID-19 presenting as KD in an adult patient.

Highlights

Coronavirus disease 2019 (COVID-19) was officially declared a pandemic on 11 March 2020 [1]
There are multiple reports about unusual manifestations of SAR-CoV-2 infection, including a new clinical entity termed: Pediatric Inflammatory Multisystem Syndrome Temporally Associated with Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (PIMS-TS), a Kawasaki-like disease in children that has been reported in countries such as Italy and the UK [12,13,14]
Similar to the recently described PIMS-TS or Kawasaki-like disease associated with COVID-19 in children who tested negative for SARS-CoV-2 polymerase chain reaction (PCR) but have SARS-CoV-2-positive antibodies, this constellation of findings, along with evidence of unregulated inflammatory response and multi-organ failure seen weeks

Summary

Introduction

Coronavirus disease 2019 (COVID-19) was officially declared a pandemic on 11 March 2020 [1]. The patient complained of one month of diffuse nonpruritic skin rash, mostly involving his back, abdomen, pelvis, and bilateral upper extremities He mentioned a recent trip to his homeland of the Dominican Republic three months prior and works at a convenience store, but he denied any known sick contacts. The patient was febrile and chest X-ray showed bilateral interstitial infiltrates. He was otherwise stable and was discharged home with antibiotics. On the eighth hospital day, the patient began to show signs of clinical improvement as evidenced by the resolution of his initial symptoms and fever From this day forward, the thrombocytopenia, renal, and liver function continued to improve until full recovery. On hospital day 12, he was discharged home in stable condition with close outpatient follow-up

Discussion

Conclusions

Findings

Disclosures

World Health Organization