A critically-ill seven-year-old boy at Pune’s Sahyadri Super Specialty Hospital made a remarkable recovery after being admitted with symptoms resembling Multisystem Inflammatory Syndrome in Children (MIS-C) and a severe respiratory condition in October.
MIS-C is a rare post-Covid serious complication in children when the immune system overreacts, attacking the body and causing widespread inflammation. The symptoms may vary, affecting multiple body systems.
Dr Ganesh Badge, consultant paediatrician at the hospital in Hadapsar, told The Indian Express that the boy from Daund was initially presented with fever, rash, abdominal pain, and rapid breathing.
Upon admission on October 20, his blood pressure was critically low, accompanied by anaemia and a low platelet count, the doctor said.
“However, despite exhaustive tests, the specific cause remained elusive,” Dr Badge said. High oxygen requirements and increased inflammatory markers led to the diagnosis of Multisystem Inflammatory Syndrome in Children (MISC), possibly linked to Covid-19. The medical team administered IVIG and steroids, managing the patient on a ventilator.
After nearly 10 days in the ICU, the patient showed significant improvement, transitioning to normal oxygen levels. Hypotension, respiratory distress, high cardiac marker (PROBNP), prolonged coagulation markers along with Covid IgG testing confirmed MISC, Dr Badge said.
He pointed out that this case presented a unique challenge with its combination of symptoms.
“The collaboration among specialists and the comprehensive care provided were instrumental in achieving this positive outcome. Steroids and intravenous immunoglobulin (IVIG) were administered as the patient’s condition worsened, necessitating five challenging days of invasive ventilation,” he said, adding that the patient had severe acute respiratory distress syndrome (ARDS) due to lung inflammation.
The road to recovery involved meticulous care, including PEEP titration, reverse IE ratio attempts, and achieving a negative fluid balance.
After 48 hours, signs of improvement were evident, as reflected in better arterial blood gas results and X-ray images. The child successfully transitioned from invasive ventilation to Synchronized Intermittent Mandatory Ventilation (SIMV) mode and, subsequently, to High-Flow Nasal Cannula (HFNC).
Ongoing care included oral and physiotherapy, emphasising a holistic approach to recuperation. After dedicated medical attention, the young patient was discharged without complications in November-end.
He had come for a follow-up treatment last week and was perfectly fine, Dr Badge added.
