Shock por enfermedad de Kawasaki post COVID-19: a propósito de un caso
Post-COVID-19 Kawasaki disease shock: a case report
Resumen
La enfermedad por coronavirus 2019 (COVID-19) afecta a gran parte de la población mundial. Aunque la mayoría de los niños con COVID-19 presentan una enfermedad asintomática, se han reportado casos con manifestaciones compatibles con estados hiperinflamatorios y/o enfermedad similar a la de Kawasaki. La enfermedad de Kawasaki (EK) es definida como una vasculitis sistémica idiopática que afecta predominantemente a niños menores de 5 años y con menor frecuencia a niños de edades mayores, permaneciendo desconocida su patogenia. El síndrome inflamatorio multisistémico pediátrico (SIM-P) se presenta como una respuesta inmunitaria adaptativa con manifestaciones clínicas cardiovasculares relevantes. Se presenta el caso de un adolescente femenino con alzas térmicas persistentes, epistaxis y hemorragia conjuntival bilateral, quien ingresa a la unidad de cuidados intensivos pediátricos (UCIP) por inestabilidad hemodinámica, con los diagnósticos de SIM-P post COVID-19 y shock por EK, tratado con corticosteroides, inmunoglobulina intravenosa, ácido acetilsalicílico y antibioticoterapia, mejorando progresivamente, con posterior alta médica y control por consulta externa.
Coronavirus disease 2019 (COVID-19) affects much of the world’s population. Although most children with COVID-19 have an asymptomatic disease, manifestations consistent with hyperinflammatory states and/or Kawasaki-like disease have been reported. Kawasaki disease (KD) is defined as an idiopathic systemic vasculitis that predominantly affects children under 5 years of age and less frequently in olders, and its pathogenesis remains unknown. Multisystem inflammatory syndrome in children (MIS-C) presents as an adaptive immune response with relevant cardiovascular manifestations. We present the case of a young female with persistent fever, epistaxis and bilateral conjunctival hemorrhage, who was admitted to the pediatric intensive care unit (PICU) due to hemodynamic instability, with the diagnoses of MIS-C post COVID-19 and shock by KD, who was treated with corticosteroids, intravenous immunoglobulin, acetylsalicylic acid and antibiotic therapy, showing progressive improvement, with subsequent medical discharge and control by external consultation.
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Depósito Legal Electrónico: ME2016000090
ISSN Electrónico: 2610-797X
DOI: https://doi.org/10.53766/GICOS
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