METHODS: The patient was a 22-year-old African American female presenting to the emergency department with fever, sore throat, and neck swelling for the past 3 days. During her initial emergency department visit, her blood pressure was stable at 110/57 mmHg, temperature of 39.4 °C, and heart rate of 150 beats per minute. While in the emergency department, she received broad-spectrum antibiotics (vancomycin and ceftriaxone) and 30 cc/kg bolus of normal saline. Originally, she was admitted to a telemetry floor. The following night, a rapid response code was called due to hypotension. At that time, her blood pressure was 80/57 mmHg. She appeared comfortable without signs of respiratory distress. She received intravenous fluids and vasopressors, and was transferred to the intensive care unit. The patient had reported a previous coronavirus disease infection a few weeks prior. She was diagnosed and treated for multisystem inflammatory syndrome in adults. Intravenous immunoglobulin infusion was initiated and completed on hospital day 5. She was weaned off vasopressors by day 6, and discharged home on day 11.
CONCLUSIONS: Our case report is an example of the presentation, diagnosis, and management of multisystem inflammatory syndrome. Our research into previous case reports illustrates the wide range of presentations, degree of end organ damage, and treatment modalities. This diagnosis needs to be considered in the presence of recent coronavirus disease infection with new-onset end organ failure, as prompt diagnosis and treatment is crucial for better outcomes.
方法:患者是一名22岁的非洲裔美国女性,因发烧到急诊科就诊,喉咙痛,和颈部肿胀过去3天。在她最初的急诊科访问期间,她的血压稳定在110/57mmHg,温度为39.4°C,心率每分钟150次.在急诊室,她接受了广谱抗生素(万古霉素和头孢曲松)和30cc/kg推注的生理盐水。最初,她被送进了遥测室.第二天晚上,由于低血压,一个快速响应代码被调用。当时,她的血压为80/57mmHg。她看起来很舒服,没有呼吸窘迫的迹象。她接受了静脉输液和血管加压药,被转移到重症监护室.患者在几周前报告了先前的冠状病毒疾病感染。她被诊断为成人多系统炎症综合征并接受治疗。在医院第5天开始并完成静脉免疫球蛋白输注。在第6天,她断奶了血管加压药,并在第11天出院回家。
结论:我们的病例报告是介绍的一个例子,诊断,和多系统炎症综合征的管理。我们对以前病例报告的研究说明了广泛的介绍,终末器官损伤程度,和治疗方式。这种诊断需要在最近的冠状病毒疾病感染伴新发终末器官衰竭的情况下考虑,因为及时的诊断和治疗对于更好的结果至关重要。