Pune : In a heartening turn of events, a 7-year-old boy has made a remarkable recovery after being admitted to the Pediatric Intensive Care Unit (PICU) with symptoms resembling Multisystem Inflammatory Syndrome in Children (MISC) and a severe respiratory condition.
The young patient initially presented with fever, rash, abdominal pain, and rapid breathing, raising serious concerns. Upon admission to Sahyadri Hospitals in Hadapsar his blood pressure was critically low, accompanied by anaemia and a low platelet count. Immediate medical intervention, including intravenous fluids and colloid administration, was initiated. Further treatments involved ionotropic support, packed cell volume (PCV) transfusion, and rigorous testing for infectious causes, such as dengue and typhoid.
Despite exhaustive tests, the specific cause remained elusive. High oxygen requirements and increase inflammatory markers led to the diagnosis of Multisystem Inflammatory Syndrome in Children (MISC), possibly linked to COVID-19. The medical team administered IVIG and steroids, managing the patient on a ventilator. After nearly 10 days in the ICU, the patient showed significant improvement, transitioning to normal oxygen levels. Hypotension, respiratory distress, high cardiac marker(PROBNP), prolonged coagulation markers along with COVID IgG testing confirmed MISC , prompting treatment under the guidance of Dr. Ganesh Badge, Consultant Paediatrics at Sahyadri Super Specialty Hospital, Hadapsar, Pune. Dr. Badge emphasized, "This case presented a unique challenge with its combination of symptoms. The collaboration among specialists and the comprehensive care provided were instrumental in achieving this positive outcome."
Steroids and intravenous immunoglobulin (IVIG) were administered as the patient's condition worsened, necessitating five challenging days of invasive ventilation. Patient had severe ARDS (Acute respiratory distress syndrome) due to lung inflammation. The road to recovery involved meticulous care, including PEEP titration, reverse IE ratio attempts, and achieving a negative fluid balance. After 48 hours, signs of improvement were evident, reflected in better arterial blood gas results and X-ray images.
The child successfully transitioned from invasive ventilation to Synchronized Intermittent Mandatory Ventilation (SIMV) mode and, subsequently, to High-Flow Nasal Cannula (HFNC). Ongoing care included oral and physiotherapy, emphasizing a holistic approach to recuperation. After two weeks of dedicated medical attention, the resilient young patient was discharged from the hospital without complications. The necessity of prompt and thorough care in paediatric severe situations is shown by this inspirational case at Sahyadri Hospitals. An important factor in the young patient's complete recovery was the teamwork of the medical staff, which was headed by Dr. Ganesh Badge.
Understanding Multisystem Inflammatory Syndrome in Children (MIS-C): MIS-C is a rare but serious complication in kids after COVID-19. It happens when the immune system overreacts, attacking the body and causing widespread inflammation. Symptoms vary, affecting multiple body systems. Though reported cases have decreased, caution is needed. Newborns born to mothers with COVID-19 are now showing MIS-C, making detection challenging without routine antibody checks. Ongoing research is crucial to understand and manage MIS-C, especially in newborns.
