Multisystem Inflammatory Syndrome in Children
Description Diagnostic criteria Treatment Referral ICD-10 code: U10.9 *Notifiable condition. DESCRIPTION A rare but serious inflammatory syndrome has been linked to COVID-19. Also known as Paediatric Inflammatory Multisystem Syndrome Temporally associated with SARS-CoV-2 infection (PIMS-TS) or Kawasaki-like syndrome. The syndrome occurs after resolution of acute COVID-19 or following
Description
Diagnostic criteria
Treatment
Referral
ICD-10 code: U10.9
*Notifiable condition.
DESCRIPTION
A rare but serious inflammatory syndrome has been linked to COVID-19. Also known as Paediatric Inflammatory Multisystem Syndrome Temporally associated with SARS-CoV-2 infection (PIMS-TS) or Kawasaki-like syndrome. The syndrome occurs after resolution of acute COVID-19 or following asymptomatic SARS-CoV-2 infection.
DIAGNOSTIC CRITERIA
Clinical presentation varies but the condition should be considered in children and adolescents (0–19 years of age) with fever ≥ 3 days AND 2 of the following:
- Rash or bilateral non-purulent conjunctivitis or mucocutaneous inflammation signs (oral, hands or feet).
- Hypotension or shock.
- Features of myocardial dysfunction, pericarditis, valvulitis, or coronary abnormalities (including ECHO findings or elevated troponin/NTproBNP).
- Evidence of coagulopathy (by PT, PTT, elevated D-dimers).
- Acute gastrointestinal problems (diarrhoea, vomiting, or abdominal pain).
AND
- Elevated markers of inflammation such as ESR, C-reactive protein, or procalcitonin.
AND
- No other obvious microbial cause of inflammation, including bacterial sepsis, staphylococcal or streptococcal shock syndromes.
AND
- Evidence of COVID-19 (RT-PCR, antigen test or IgG serology positive), or likely contact with patients with COVID-19.
TREATMENT
- If the child meets the above case definition, evaluate for shock and manage accordingly (see: Shock).
- Consult a tertiary centre for advice and referral.
REFERRAL
- All cases.
Standard Treatment Guidelines and Essential Medicines List for South Africa Paediatric Hospital _2023, 5th edition_Updated July 2024
Chapter 8: Infective/Infectious Diseases, 8.32.1 Multisystem Inflammatory Syndrome In Children (mis-c)