Cavitary Lung Lesions in a Neonate: Potential Manifestation of COVID-19
related Multisystem Inflammatory Syndrome
Abstract
Background: The hyperinflammatory state of Multisystem inflammatory
syndrome in children (MIS-C) predisposes to thromboembolic
complications. We report a neonate with multiple cavitary lesions in
lung, which we suspect could be a manifestation of MIS following
maternal COVID-19 infection during pregnancy. Case report: 8 day old
neonate was referred with fever and fast breathing. Mother was positive
for COVID-19 in 29th week. COVID-19 RT-PCR was negative, however,
antibodies were positive. He had increased leucocyte count, and elevated
levels of C-Reactive protein(CRP), Procalcitonin, Ferritin, Lactate
dehydrogenase(LDH), and D-dimer along with bilateral reticulonodular
opacities on chest radiograph and multiple nodules with evidence of
cavitation in both lungs on Chest Tomography. All cultures were
negative. A possible diagnosis of MIS was made. Infant was treated with
Intravenous Immunoglobulin (IVIG) which he responded to with resolution
of symptoms. Conclusion: Neonates exposed to COVID-19 should be
evaluated for thromboembolic complications and IVIG can be one of the
treatment modalities.