KEY CLINICAL MESSAGE
Clinicians should to be aware of Multisystem Inflammatory Syndrome in Adult and Acute Limb Ischemia caused by COVID-19.
CASE DESCRIPTION
A 72-year-old man presented with a history of dyspnea and left lower extremity pain for 1 week. Contrast-enhanced computed tomography scans showed multiple arterial occlusions (Figure 1A, B) and no deep venous thrombosis, bilateral lung diffuse consolidation (Figure 1C), contrast-delayed areas in the myocardium (Figure 1D), and contrast enhancement in the aortic walls (Figure 1E). The patient needed noradrenaline. Laboratory examinations showed procalcitonin up to 40.60 ng/mL, C-reactive protein up to 31.57 mg/dL, creatinine kinase up to 13,861 U/L, D-dimer up to 258.8 µg/mL, high-sensitivity cardiac troponin I up to 9.014 ng/mL, platelets down to 83000 /µL. Real-time polymerase chain reaction via a nasopharyngeal swab was positive for COVID-19. Above all, the patients met the criteria of Multisystem Inflammatory Syndrome in Adults (MIS-A) Case Definition by Centers for Disease Control and Prevention (1).
Despite we treated the patient with dexamethasone, the patient died on the 17th day of hospitalization as a result of uncontrolled circulatory failure and sepsis.
Acknowledgment: We thank Forte Science Communications, Inc., for proofreading the manuscript.
REFERENCE
Available fromhttps://www.cdc.gov/mis/mis-a/hcp.html
Author contributions:
Hiroshi Kobe: writing original draft
Akihiro Ito: writing review and editing
Tadashi Ishida: supervision, writing review and editing
INFORMED CONSENT
Informed consent was obtained.