Pediatric inflammatory multisystemic syndrome temporally associated with SARS-CoV-2 infection, a severe and unpredictable entity

Abstract

In children, COVID-19 infection has usually a mild course. However, cases of children with multisystemic inflammatory syndrome presenting a variable clinical expression linked to a recent or active infection by SARS-CoV-2 were reported in April 2020. This report presents a case of pediatric inflammatory multisystemic syndrome temporally associated with SARS-CoV-2 infection (PIMS-TS), whose diagnosis was difficult given the variability in clinical expression. The differential diagnosis is shown and highlights the need to take into account all the signs and symptoms to get an early diagnosis, optimal management and reduce secondary morbidity and mortality. This variability in clinical manifestations with clinical and analytical features similar to Kawasaki syndrome, toxic shock syndrome or macrophage activation makes it difficult to reach an early diagnosis. It shows the need for a multidisciplinary assessment of different pediatric specialists, as well as to follow recommendations and protocols for the diagnosis, stabilization and treatment in order to homogenize the management in the emergency and hospitalization departments.