Unusual Presentation of MIS-C Mimicking Deep Neck Infection In Two Children

Introduction

Coronavirus disease 2019 (COVID-19) can lead to a life-threatening cytokine storm that was first reported as pediatric inflammatory multisystem syndrome temporally associated with COVID-19 (PIMS-TS) by the UK Royal College of Paediatrics and Child Health (RCPCH) in April, 2020 (RCPCH Health Policy Team, 2020). This novel condition was named “multisystem inflammatory syndrome in children (MIS-C)” by the Centers for Disease Control and Prevention (CDC) in May 2020 (CDC Health Alert Network, 2020). Data on the clinical presentation and epidemiological characteristics of children with MIS-C are still limited and evolving daily (Nakra NA et al. Children (Basel, Switzerland) 2020; 7: 69). Two or more organ involvement (i. e., cardiac, renal, respiratory, hematological, gastrointestinal, dermatological, and neurological) are among the CDC case definition criteria (CDC Health Alert Network, 2020). The clinical findings of MIS-C are similar to Kawasaki disease (KD), an acute multisystem vasculitis of unknown etiology that occurs in infants and children (Nakra NA et al. Children (Basel, Switzerland) 2020; 7: 69. Tona R et al. Auris Nasus Larynx 2014; 41:4 55–458). It has been previously reported that some cases of KD initially presented with retropharyngeal abscesses or cellulitis (Tona R et al. Auris Nasus Larynx 2014; 41: 455–458).

Herein, we report two cases with clinical pictures mimicking deep neck infection as an initial presentation of MIS-C. We emphasized that lymphadenopathy and retropharyngeal phlegmon/edema may be the initial challenging clinical presentation of MIS-C.

Publication History

Article published online:
13 September 2021