Paediatric multisystem inflammatory syndrome in a ten-year old boy in a resource limited setting: a case for locally developed diagnostic criteria

Abstract

Paediatric multisystem inflammatory syndrome (PMIS) occurs two to four weeks following exposure to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus 2019 (COVID-19). It is characterized by the presence of persistent fever, inflammation and organ dysfunction. We present AE a 10-year old Nigerian boy who presented to the children emergency room with a history of continuous and high grade fever with back and multiple joint pains. While on admission he developed cough, difficulty with breathing, bleeding from the gums and altered consciousness which progressed to loss of consciousness. Complete blood count showed neutrophilia of 82.9%, lymphopenia of 9.8%, thrombocytopenia of 142,000 cells/mm3, elevated erythrocyte sedimentation rate of 75mm/hr, chest radiograph findings of ground glass appearance and consolidation in all lung lobes bilaterally with a positive reverse transcriptase-polymerase chain reaction test for COVID-19 which met the Centre for Disease Control criteria for the diagnosis of pediatric multisystem inflammatory syndrome. The patient was treated with intranasal oxygen, transfused with fresh whole blood, analgesics and antifailure drugs. His condition however deteriorated while on admission and died on the seven days of admission.