COVID-19 multisystemic inflammatory syndrome in adults: a not to be missed diagnosis

BMJ Case Rep. 2021 Apr 13;14(4):e241696. doi: 10.1136/bcr-2021-241696.

Abstract

We report COVID-19 multisystemic inflammatory syndrome in an adult patient with an atypical presentation (mild abdominal pain) and a negative (repeated) reverse transcriptase-PCR, in the absence of lung involvement on lung ultrasound. In this case, focused cardiac ultrasound revealed signs of myopericarditis and enabled us to focus on the problem that was putting our patient in a perilous situation, with a quick, non-time-consuming and easy-to-access technique. Serology test was performed and SARS-CoV-2 infection was confirmed more than a week after admission to the coronary unit. As the patient had a general good appearance, the potential implications of missing this diagnosis could have been fatal.

Keywords: TB and other respiratory infections; cardiovascular medicine; infectious diseases; ultrasonography.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain
  • Adult
  • COVID-19 / complications
  • COVID-19 / diagnosis*
  • COVID-19 Serological Testing
  • Echocardiography
  • Humans
  • Lung / diagnostic imaging
  • Male
  • Myocarditis / diagnostic imaging*
  • Myocarditis / virology
  • Pericarditis / diagnostic imaging*
  • Pericarditis / virology
  • Systemic Inflammatory Response Syndrome / diagnosis
  • Systemic Inflammatory Response Syndrome / virology*
  • Ultrasonography