Refractory Cardiogenic Shock Secondary to Acute Myocarditis in a Child with Multisystem Inflammatory Syndrome Associated with COVID-19: A Case Report

Abstract

Children with Coronavirus disease 2019 infection usually have mild symptoms but rarely may present with a life-threatening condition called a multisystem inflammatory syndrome. We report a case of COVID-19-related multisystem inflammatory syndrome in an 8-year-old boy who presented with cardiogenic shock due to acute myocarditis with no features of Kawasaki disease. Cardiogenic shock was refractory to fluids and inotropes. Later, this case was successfully managed with hydrocortisone and intravenous immunoglobulin. Therefore, this case report highlights keeping a lookout for such atypical presentations and early referral to a higher center for timely intervention and aggressive therapy specifically directed against the underlying inflammatory process to ameliorate the outcomes.

Keywords

• cardiogenic shock; COVID-19; kawasaki disease; myocarditis; Nepal.