Aidan: Created page with "== Background == * Also known as pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS or PIMS) * A syndrome caused by SARS-CoV-2..."

2021-11-16T15:24:08Z

Created page with "== Background == * Also known as pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS or PIMS) * A syndrome caused by SARS-CoV-2..."

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== Background ==

* Also known as pediatric inflammatory multisystem syndrome temporally associated with [[SARS-CoV-2]] (PIMS-TS or PIMS)
* A syndrome caused by [[SARS-CoV-2]] infection, primarily in children
* Characterized by immune dysregulation with multiple systems involved, typically severe and requiring hospitalization

=== Epidemiology ===

* Median age is 7 to 10 years old, but with a range of 1 month to 20 years
* Slightly more common in boys than girls
* Most common comorbidities are [[asthma]] and [[obesity]], though unclear that they are particularly strong risk factors

== Clinical Manifestations ==

* Onset typically 2 to 6 weeks following infection with [[SARS-CoV-2]]

== Case Definition ==

=== World Health Organization ===

* Children and adolescents aged 0 to 19 years with fever for more than 3 days
* AND two of the following:
** Rash or bilateral non-purulent conjunctivitis or muco-cutaneous inflammation signs (oral, hands or feet)
** Hypotension or shock
** Features of myocardial dysfunction, pericarditis, valvulitis, or coronary abnormalities (including ECHO findings or elevated Troponin/NT-proBNP)
** Evidence of coagulopathy (by PT, PTT, elevated d-Dimers)
** Acute gastrointestinal problems (diarrhoea, vomiting, or abdominal pain)
* AND elevated markers of inflammation such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), or procalcitonin
* AND no other obvious microbial cause of inflammation, including bacterial sepsis, staphylococcal or streptococcal shock syndromes
* AND evidence of the coronavirus disease 2019 (COVID-19) (reverse transcription polymerase chain reaction (RT-PCR), antigen test or serology positive), or likely contact with patients with COVID-19

=== US CDC ===

* An individual aged younger than 21 years presenting with fever (greater than 38.0°C for greater than or equal to 24 hours, or report of subjective fever lasting greater than or equal to 24 hours), laboratory evidence of inflammation, and evidence of clinically severe illness requiring hospitalization, with multisystem (more than two) organ involvement (cardiac, renal, respiratory, hematologic, gastrointestinal, dermatologic or neurological)
* AND no alternative plausible diagnoses
* AND positive for current or recent [[SARS-CoV-2]] infection by RT-PCR, serology, or antigen test; or exposure to a suspected or confirmed COVID-19 case within the four weeks prior to the onset of symptoms

=== UK RCPCH ===

* A child presenting with persistent fever, inflammation (neutrophilia, elevated [[CRP]] and lymphopenia) and evidence of single or multi-organ dysfunction (shock, cardiac, respiratory, renal, gastrointestinal or neurological disorder) with additional features. This may include children fulfilling full or partial criteria for Kawasaki disease
* AND exclusion of any other microbial cause, including bacterial sepsis, [[Staphylococcal toxic shock syndrome|staphylococcal]] or [[Streptococcal toxic shock syndrome|streptococcal shock syndromes]], infections associated with [[myocarditis]] such as [[Enterovirus]] (waiting for results of these investigations should not delay seeking expert advice)
* AND [[SARS-CoV-2]] PCR testing may be positive or negative

=== Canadian Paediatric Society ===

* Persistent fever (higher than 38.0°C for three or more days) and elevated inflammatory markers (CRP, ESR, or ferritin)
* AND one of both of the following:
** Features of [[Kawasaki disease]] (complete or incomplete)
** [[Toxic shock syndrome]] (typical or atypical)
* AND no alternative etiology to explain the clinical presentation
* AND patients need not have positive SARS-CoV-2 status for consideration

Multisystem inflammatory syndrome in children - Revision history

Aidan: Created page with "== Background == * Also known as pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS or PIMS) * A syndrome caused by SARS-CoV-2..."