Multisystem inflammatory syndrome with refractory cardiogenic shock due to acute myocarditis and mononeuritis multiplex after SARS-CoV-2 infection in an adult.
Swiss Med Wkly
; 150: w20387, 2020 11 02.
Article
in English
| MEDLINE | ID: covidwho-922917
ABSTRACT
A 22-year-old male with a typical history of pauci-symptomatic COVID-19 3 weeks earlier, confirmed by positive serology for SARS-CoV-2 (IgG), was admitted to the intensive care unit because of severe myocarditis with refractory cardiogenic shock that required extracorporeal life support. Due to a clinical presentation suggestive of Kawasaki-like disease with coronary aneurysm and severe systemic inflammation, intravenous immunoglobulins were administered in combination with tocilizumab. The initial clinical course was favourable with these treatments. However, the patient subsequently developed a severe mononeuritis multiplex leading to bilateral foot drop, which required intensive immunosuppressive therapy (corticosteroids, cyclophosphamide and rituximab). The clinical presentation meets the criteria for multisystem inflammatory syndrome associated with SARS-CoV-2, but includes very severe organ damages. Early recognition, a multidisciplinary approach and aggressive therapeutic intervention can lead to a favourable outcome.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Shock, Cardiogenic
/
Systemic Inflammatory Response Syndrome
/
Mononeuropathies
/
COVID-19
/
Myocarditis
Type of study:
Case report
/
Prognostic study
Topics:
Long Covid
Limits:
Adult
/
Humans
/
Male
/
Young adult
Language:
English
Journal:
Swiss Med Wkly
Journal subject:
Medicine
Year:
2020
Document Type:
Article
Affiliation country:
Smw.2020.20387
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