MIS-C-Implications for the Pediatric Surgeon: An Algorithm for Differential Diagnostic Considerations
Abstract
:1. Introduction
2. Methods
3. Results
3.1. Patient 1
3.2. Patient 2
3.3. Patient 3
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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WHO | CDC | Royal College | P 1 | P 2 | P 3 | |
---|---|---|---|---|---|---|
Systematic inflammation | fever ≥ 3 days and elevated inflammatory parameters (ESR, CRP, PCT) | fever ≥ 38 °C for ≥ 24 h, elevated inflammatory parameters | persistent fever > 38.5°, lymphadenopathy, elevated inflammatory parameters | yes | yes | yes |
Skin and mucosa | rash or bilateral conjunctivitis or mucocutaneous signs | rash, muco-cutaneous lesions | rash, conjunctivitis/swollen hands and feet | yes | yes | no |
Fluid balance | hypotension or shock | hypotension or shock | hypotension | yes | no | no |
Heart | laboratory or echocardio-graphical findings of myocardial dysfunction, pericarditis, valvulitis, coronary abnormalities | laboratory findings of cardiac dysfunction, myocarditis | laboratory, ECG or echocardiographical findings of myocardial dysfunction, pericarditis, valvulitis, coronary abnormalities | yes | yes | yes |
Coagulation | evidence of coagulopathy (PT, PTT, D-dimers) | Elevated d-dimers and fibrinogen | High d-dimers, abnormal fibrinogen | yes | yes | yes |
Gastro-intestinal tract | diarrhea, vomiting, abdominal pain | diarrhea, vomiting | diarrhea, vomiting, abdominal pain, ultrasound with colitis, ileitis, lymphadenopathyascites, hepato-splenomegaly | yes | yes | yes |
Other organ systems | acute kidney injury | yes | yes | no | ||
exclusion of microbial cause | no alternative plausible diagnosis | exclusion of microbial cause including toxic shock syndromes | yes | yes | yes | |
Evidence of SARS-CoV-2 | PCR, antigen test, serology or likely contact with SARS-CoV-2 positive person | positive PCR, serology or antigen test or exposure within 4 weeks prior to onset of symptoms | positive SARS-CoV-2-PCR | yes | yes | yes |
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Manz, N.; Höfele-Behrendt, C.; Bielicki, J.; Schmid, H.; Matter, M.S.; Bielicki, I.; Holland-Cunz, S.; Gros, S.J. MIS-C-Implications for the Pediatric Surgeon: An Algorithm for Differential Diagnostic Considerations. Children 2021, 8, 712. https://doi.org/10.3390/children8080712
Manz N, Höfele-Behrendt C, Bielicki J, Schmid H, Matter MS, Bielicki I, Holland-Cunz S, Gros SJ. MIS-C-Implications for the Pediatric Surgeon: An Algorithm for Differential Diagnostic Considerations. Children. 2021; 8(8):712. https://doi.org/10.3390/children8080712
Chicago/Turabian StyleManz, Nora, Claudia Höfele-Behrendt, Julia Bielicki, Hanna Schmid, Matthias S. Matter, Isabella Bielicki, Stefan Holland-Cunz, and Stephanie J. Gros. 2021. "MIS-C-Implications for the Pediatric Surgeon: An Algorithm for Differential Diagnostic Considerations" Children 8, no. 8: 712. https://doi.org/10.3390/children8080712