ABSTRACT:
Background: The hyperinflammatory state of Multisystem
inflammatory syndrome in children (MIS-C) predisposes to thromboembolic
complications. We report a neonate with multiple cavitary lesions in
lung, which we suspect could be a manifestation of MIS following
maternal COVID-19 infection during pregnancy.
Case report : 8 day old neonate was referred with fever and fast
breathing. Mother was positive for COVID-19 in 29thweek. COVID-19 RT-PCR was negative, however, antibodies were positive.
He had increased leucocyte count, and elevated levels of C-Reactive
protein(CRP), Procalcitonin, Ferritin, Lactate dehydrogenase(LDH), and
D-dimer along with bilateral reticulonodular opacities on chest
radiograph and multiple nodules with evidence of cavitation in both
lungs on Chest Tomography. All cultures were negative. A possible
diagnosis of MIS was made. Infant was treated with Intravenous
Immunoglobulin (IVIG) which he responded to with resolution of symptoms.
Conclusion: Neonates exposed to COVID-19 should be evaluated
for thromboembolic complications and IVIG can be one of the treatment
modalities.
Keywords : COVID-19, Neonate, thromboembolism, Pulmonary
cavities, Multisystem Inflammatory syndrome