Overlap of severe dengue with multisystem inflammatory syndrome in children due to SARS-CoV-2 infection: A case series from a tertiary care center of Central India

Abstract

India is currently facing a double burden of severe dengue and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Co-infection/complication due to these viruses can result in severe morbidity. We present five cases of severe dengue with multisystem inflammatory syndrome in children (MIS-C) due to SARS-CoV-2 infection in children. All children presented with shock with variable degrees of plasma leakage. They were treated initially as severe dengue cases; however, due to refractory symptoms such as persistent fever and inotropic requirement, an alternate diagnosis was suspected and established. They were successfully managed according to the World Health Organization Dengue Shock Syndrome and MIS-C Guidelines with intravenous (IV) fluids, methylprednisolone, aspirin, and IV immunoglobulin. Severe dengue in endemic regions overlapping with MIS-C makes it difficult to diagnose which needs early recognition and appropriate management.

Keywords

• multisystem inflammatory syndrome in children
• severe acute respiratory syndrome coronavirus 2
• severe dengue