Aseptic meningitis in multisystem inflammatory syndrome in children associated with coronavirus disease 2019: a case report
Abstract Background As the coronavirus disease 2019 infections are still ongoing, there is an increasing number of case reports and case series with various manifestations of life-threatening multisystem inflammatory syndrome in children . Our case aims to remind all providers to scrutinize for clin...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-10-01
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| Series: | Journal of Medical Case Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13256-022-03617-y |
| _version_ | 1817979593212035072 |
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| author | Alije Keka-Sylaj Atifete Ramosaj Arbana Baloku Qëndresa Beqiraj Petrit Gjaka |
| author_facet | Alije Keka-Sylaj Atifete Ramosaj Arbana Baloku Qëndresa Beqiraj Petrit Gjaka |
| author_sort | Alije Keka-Sylaj |
| collection | DOAJ |
| description | Abstract Background As the coronavirus disease 2019 infections are still ongoing, there is an increasing number of case reports and case series with various manifestations of life-threatening multisystem inflammatory syndrome in children . Our case aims to remind all providers to scrutinize for clinical manifestations, including neurological symptoms, which may mimic aseptic meningitis. Case presentation A 5-year-old Albanian male child with obesity was admitted to the pediatric intensive care unit due to persistent fever, headache, vomiting, abdominal pain, mucocutaneous manifestations, and fatigue. Initial laboratory results revealed high level of inflammatory markers, including C-reactive protein of 156.8 mg/l, erythrocyte sedimentation rate of 100 mm/hour, procalcitonin of 13.84, leukocytosis with neutrophilia, and lymphopenia. Liver and renal functions, and capillary blood electrolytes (Na, K, Ca), were also altered. Cerebrospinal fluid was slightly turbid, with a white blood cell count of 128/mm3 (80% mononuclear cells and 20% polymorphonuclear), consistent with aseptic meningitis. The clinical presentation with prolonged fever, multiorgan dysfunction, and elevated inflammatory markers, with no plausible alternative diagnosis, matches the case definition of multisystem inflammatory syndrome in children. Combining corticosteroid methylprednisolone with intravenous immunoglobulin was effective. Conclusions Apart from the most common presentation of multisystem organ dysfunction, neurological manifestations of multisystem inflammatory syndrome in children such as aseptic meningitis, may be present as an immune response post-viral to coronavirus disease 2019. Given the rapid deterioration of children with multisystem inflammatory syndrome, early treatment with immunoglobulins and corticosteroids should be considered. |
| first_indexed | 2024-04-13T22:44:39Z |
| format | Article |
| id | doaj.art-6943eb2ea6514766b178690b5059331e |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-04-13T22:44:39Z |
| publishDate | 2022-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-6943eb2ea6514766b178690b5059331e2022-12-22T02:26:28ZengBMCJournal of Medical Case Reports1752-19472022-10-011611710.1186/s13256-022-03617-yAseptic meningitis in multisystem inflammatory syndrome in children associated with coronavirus disease 2019: a case reportAlije Keka-Sylaj0Atifete Ramosaj1Arbana Baloku2Qëndresa Beqiraj3Petrit Gjaka4Institute of Anatomy, Pediatric Clinic, Faculty of Medicine, University of PrishtinaInstitute of Anatomy, Pediatric Clinic, Faculty of Medicine, University of PrishtinaPediatric Clinic, University Clinical Center of KosovoPediatric Clinic, University Clinical Center of KosovoPediatric Clinic, University Clinical Center of KosovoAbstract Background As the coronavirus disease 2019 infections are still ongoing, there is an increasing number of case reports and case series with various manifestations of life-threatening multisystem inflammatory syndrome in children . Our case aims to remind all providers to scrutinize for clinical manifestations, including neurological symptoms, which may mimic aseptic meningitis. Case presentation A 5-year-old Albanian male child with obesity was admitted to the pediatric intensive care unit due to persistent fever, headache, vomiting, abdominal pain, mucocutaneous manifestations, and fatigue. Initial laboratory results revealed high level of inflammatory markers, including C-reactive protein of 156.8 mg/l, erythrocyte sedimentation rate of 100 mm/hour, procalcitonin of 13.84, leukocytosis with neutrophilia, and lymphopenia. Liver and renal functions, and capillary blood electrolytes (Na, K, Ca), were also altered. Cerebrospinal fluid was slightly turbid, with a white blood cell count of 128/mm3 (80% mononuclear cells and 20% polymorphonuclear), consistent with aseptic meningitis. The clinical presentation with prolonged fever, multiorgan dysfunction, and elevated inflammatory markers, with no plausible alternative diagnosis, matches the case definition of multisystem inflammatory syndrome in children. Combining corticosteroid methylprednisolone with intravenous immunoglobulin was effective. Conclusions Apart from the most common presentation of multisystem organ dysfunction, neurological manifestations of multisystem inflammatory syndrome in children such as aseptic meningitis, may be present as an immune response post-viral to coronavirus disease 2019. Given the rapid deterioration of children with multisystem inflammatory syndrome, early treatment with immunoglobulins and corticosteroids should be considered.https://doi.org/10.1186/s13256-022-03617-yMIS-CCOVID 19ChildrenAseptic meningitis |
| spellingShingle | Alije Keka-Sylaj Atifete Ramosaj Arbana Baloku Qëndresa Beqiraj Petrit Gjaka Aseptic meningitis in multisystem inflammatory syndrome in children associated with coronavirus disease 2019: a case report Journal of Medical Case Reports MIS-C COVID 19 Children Aseptic meningitis |
| title | Aseptic meningitis in multisystem inflammatory syndrome in children associated with coronavirus disease 2019: a case report |
| title_full | Aseptic meningitis in multisystem inflammatory syndrome in children associated with coronavirus disease 2019: a case report |
| title_fullStr | Aseptic meningitis in multisystem inflammatory syndrome in children associated with coronavirus disease 2019: a case report |
| title_full_unstemmed | Aseptic meningitis in multisystem inflammatory syndrome in children associated with coronavirus disease 2019: a case report |
| title_short | Aseptic meningitis in multisystem inflammatory syndrome in children associated with coronavirus disease 2019: a case report |
| title_sort | aseptic meningitis in multisystem inflammatory syndrome in children associated with coronavirus disease 2019 a case report |
| topic | MIS-C COVID 19 Children Aseptic meningitis |
| url | https://doi.org/10.1186/s13256-022-03617-y |
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