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- Shuichi Asano, Tomofumi Shibata, Yohei Tsunoda, Azusa Ishii, Takafumi Kayukawa, Masahiro Kobayashi, Masami Orinaka, Shoko Miyamatsu, Yoshio Ryuge, and Kimihiro Kato.
- Department of Respirology, Japan Community Health Care Organization Chukyo Hospital, Japan.
- Intern. Med. 2023 Sep 1; 62 (17): 257125752571-2575.
AbstractA 21-year-old man on hemodialysis was hospitalized for coronavirus disease 2019 (COVID-19) pneumonia. After admission, he had a persistent high fever and developed erythema induratum on his extremities. Laboratory tests conducted 25 days after onset showed markedly increased procalcitonin (PCT) levels (>100 ng/mL). The patient developed impaired consciousness and hypotensive shock and required endotracheal intubation. Based on the presence of erythema induratum and multiorgan dysfunction, he was diagnosed with multisystem inflammatory syndrome (MIS). The MIS resolved after treatment with intravenous immunoglobulin and methylprednisolone. This report illustrates that MIS can occur in adults and may be accompanied by high PCT levels.
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