Multisystem inflammatory syndrome in children (MIS-C) is a condition in which inflammation of different body parts such as the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs occurs.
Most children diagnosed with MIS-C will recover with medical care, but the condition can be serious, and in some cases, fatal.
- The cause of MIS-C is unknown but it seems to be linked to the virus that causes COVID-19, as many children who have developed MIS-C have had COVID-19 or been exposed to someone who has.
- Multisystem inflammatory syndrome in children commonly affects children about eight to nine years old, but it can affect infants and young adults.
- MIS-C is rare, and it is not entirely known how exactly the condition affects children and why some children develop MIS-C and others do not.
What Are Symptoms of Pediatric Multisystem Inflammatory Syndrome (PMIS)?
Symptoms of pediatric multisystem inflammatory syndrome (MIS-C) usually occur between two and six weeks (with an average of four weeks) following infection with the virus that causes COVID-19.
Symptoms of pediatric multisystem inflammatory syndrome include:
- Fever of 100.4 degrees Fahrenheit or higher lasting 24 hours or more PLUS more than one of the following:
- Abdominal/stomach pain
- Red/bloodshot eyes
- Low blood pressure (hypotension), which can cause:
- Skin rash
- Neck pain
Call 911 and get your child to a hospital’s emergency immediately if your child shows any of the following symptoms:
- Difficulty breathing/shortness of breath
- Persistent pain or pressure in the chest
- New confusion
- Inability to wake up or stay awake
- Vomiting and not able to hold anything down
- Fainting or passing out
- Very rapid heart rate
- Pale, gray, or blue-colored skin, lips, or nail beds
Notify the medical staff if your child has been diagnosed with COVID-19 or has been exposed to the virus.
How Is Pediatric Multisystem Inflammatory Syndrome (PMIS) Diagnosed?
Pediatric multisystem inflammatory syndrome (MIS-C) is diagnosed with a patient history including questions about any recent diagnosis of COVID-19 or any known exposure to COVID-19, and a physical examination.
Tests might include:
- COVID tests
- PCR test
- Antigen test
- Antibody testing
- Blood and urine tests
- Complete Blood Count (CBC)
- Blood chemistries
- Liver function tests
- Erythrocyte Sedimentation Rate (ESR)
- C-reactive protein (CRP)
- Blood cultures
- Creatinine Phosphokinase (CPK)
- Chest X-ray
- Abdominal ultrasound
- Computerized tomography (CT) scan
- Cardiac testing
- Heart ultrasound (echocardiogram)
- Cardiac enzyme or troponin testing
- B-type natriuretic peptide (BNP) or NT-proBNP
What Is the Treatment for Pediatric Multisystem Inflammatory Syndrome (PMIS)?
Pediatric multisystem inflammatory syndrome (MIS-C) usually requires treatment in the hospital, and in some cases, the pediatric intensive care unit (PICU).
Treatment for MIS-C involves supportive care for symptoms and medicines to treat inflammation, such as:
- Intravenous (IV) fluids
- Heart medicines
- Calcium channel blockers
- Antiarrhythmic medicines
- Respiratory support
- High-flow nasal oxygen
- Noninvasive ventilation
- Positive airway pressure (CPAP or BiPAP)
- Extracorporeal membranous oxygenation (ECMO) (used in rare, severe cases)
- Anti-inflammatory treatments
- Intravenous immune globulin (IVIG)
- Non-steroidal anti-inflammatory medications
- Low-dose aspirin may be used due to concerns for coronary artery involvement
- Antibiotics to treat potential sepsis while awaiting bacterial cultures
- Medicines to prevent blood clots are often used
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