Case Report on a Young Patient with Multisystem Inflammatory Syndrome in Adult (MIS-A)

Author(s): Rakhee Baruah* and Reshu Gupta

Background: A healthy 22 year old man presented with clinical and laboratory characteristics of multisystem inflammatory syndrome resembling MIS-C with cardiac dysfunction requiring intensive care support that included mechanical ventilation and vasopressor support. Aim: To present a rare case of Multisystem Inflammatory Syndrome in Adult (MIS-A). Case Report: The patient presented with 5 days of fever, profuse sweating, vomiting and loose stools. Patient was otherwise healthy with no prior medical illness and was never a diagnosed case of COVID 19. At the time of admission, patient was found to be in shock with leukocytosis, conjunctivitis, acute kidney injury, cardiac dysfunction, acute hepatitis with both COVID antigen and RT– PCR negative. The patient required ICU admission with ventilatory and vasopressor support. MIS-A secondary to COVID19 was suspected on the basis of his clinical presentation and a positive COVID Antibody report. Patient improved clinically with IV steroids, IVIG, heparin, and Critical Care management and support. Conclusion: A small portion of patients present with late onset complications following asymptomatic COVID 19 infection. This Stage includes Multiorgan dysfunction in the setting of severe inflammation. MIS-C has become a recognized syndrome whereas a parallel syndrome in adults has not been well defined. So MIS-A should be considered in adults presenting with features compatible with MIS-C like illness, including shock and cardiac dysfunction.


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