Vasodilatory shock in 15 years old girl in Bulgaria

Abstract

Background Multisystem Inflammatory Syndrome in children related to COVID-19 (MIS-C) is a new condition the aftermath of which is yet to be studied both in Bulgaria and globally. Up to mid December 2020, world COVID-19 fatalities are put at 1 582 674, according WHO statistics. Case Presentation Summary We present a 15 years old patient with MIS-C, diagnosed with acute abdomen, operated andtreated for septic shock syndrome. The current situation represents a major clinical challenge in part due to the complex differential diagnosis involved: acute abdomen, septic shock, autoimmune diseases (Lupus erythematosus, Juvenile idiopathic arthritis, Kawasaki disease, Acquired immune deficiency, Crohn`s disease, Ulcer colitis), acute myocarditis. At the same time, other symptoms observed in children with COVID-19 such as skin rashes, lymphadenopathy, conjunctivitis are not presented inour patient. We did not observe any myocardial injury, however she went into an acute vasodilatory shock with tachycardia, reduced kidney perfusion pressure and oliguria. Learning Points/Discussion Effects of SARS-CoV-2 infection on patients will be asubject of analysis and clinical research. Differential diagnosisof the multisystem inflammation syndrome in children, clinicalexperience and newtherapeutic strategies are the key to reducing mortality and long-term complicationsin the affected patients.