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- W3207347832 abstract "Introduction: Multisystem inflammatory syndrome in children (MIS-C) is a rare, life-threatening sequela of COVID-19 infection in pediatric patients. We review the literature and describe a novel presentation of severe head and neck manifestations in 2 MIS-C patients. Method: A case report and PubMed literature search were conducted. Results: Two adolescent patients were evaluated at a tertiary care children's hospital for headache, fever, and neck pain. Examination demonstrated massive cervical lymphadenopathy (LAD), neck cellulitis, and tonsillopharyngitis. Laboratory findings demonstrated C-reactive protein elevation and negative COVID-19 polymerase chain reaction (PCR) testing. Computed tomography (CT) imaging demonstrated extensive multicompartment head and neck phlegmonous fluid collections. Steroids and broad-spectrum antibiotics were initiated. Rapid resolution of neck pain and fever occurred but was succeeded by the development of cardiogenic shock requiring critical care transfer and initiation of vasopressors. Positive COVID-19 immunoglobulin G testing was followed by the initiation of intravenous immunoglobulin and normalization of cardiac function in both patients with subsequent discharge home in stable condition. PubMed reviews for articles highlighting MIS-C presentations and head and neck manifestations were included. The defining presenting characteristics are typically prolonged fever, abdominal pain, and cardiac involvement without any signs of pneumonia on chest CT. Cervical LAD and sore throat are rare presenting symptoms of MIS-C but common in the general pediatric population. Otolaryngologists are frequently engaged to help manage patients with complications such as severe tonsillitis or deep neck fluid collections. A negative COVID-19 polymerase chain reaction may falsely lower the threshold of suspicion of a SARS-CoV-2-related illness;however, awareness of unusual head and neck manifestations as a presentation of MIS-C may help the early recognition and treatment of this potentially fatal syndrome. Conclusion: COVID-19 should be considered in the differential for atypical head and neck infection in the pediatric patient, as this may serve as a precursor to MIS-C." @default.
- W3207347832 created "2021-10-25" @default.
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- W3207347832 date "2021-01-01" @default.
- W3207347832 modified "2023-09-26" @default.
- W3207347832 title "Atypical head and neck infections as a precursor to MIS-C" @default.
- W3207347832 hasPublicationYear "2021" @default.
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