Multisystem Inflammatory Syndrome after COVID-19 Vaccination (MIS-V) Presenting with Retropharyngeal Phlegmon in a 15-year-old Boy in Japan

Takeshi Koga^1, , Moe Yoshimura¹, Sakiko Kubo¹, Miki Nagai¹, Katsuhiko Tabata¹, Hiromi Teranishi¹, Misato Fujino¹, Hiroshi Kawana¹, Ikuma Musha¹ and Yuko Akioka¹

¹Department of Pediatrics, Saitama Medical University Hospital, Saitama, Japan

Cite this paper

Takeshi Koga, Moe Yoshimura, Sakiko Kubo, Miki Nagai, Katsuhiko Tabata, Hiromi Teranishi, Misato Fujino, Hiroshi Kawana, Ikuma Musha and Yuko Akioka. Multisystem Inflammatory Syndrome after COVID-19 Vaccination (MIS-V) Presenting with Retropharyngeal Phlegmon in a 15-year-old Boy in Japan. American Journal of Medical Case Reports. 2022; 10(2):35-38. doi: 10.12691/AJMCR-10-2-4

Abstract

Our case report presents a young patient vaccinated for coronavirus disease 2019 (COVID-19) who developed multisystem inflammatory syndrome in children (MIS-C), which was later confirmed to be multisystem inflammatory syndrome after vaccination (MIS-V). 15-year-old boy previously infected by COVID-19 who received the first dose of COVID-19 vaccine 50 days later and developed fever, lethargy, headache, diarrhea, nausea, lip swelling, neck pain, and dysphagia. Contrast-enhanced computed tomography revealed a low absorption area with no contrast effect was observed in the posterior pharyngeal gap suggesting retropharyngeal phlegmon. He was diagnosed to be MIS-V level 2 based on the Brighton Collaboration Case Definition and improved by Intravenous immunoglobulin (IVIG). The frequency of neck symptoms in MIS-V is higher than in other febrile diseases, and many cases of retropharyngeal phlegmon are observed. In addition, pediatric COVID-19 is mostly asymptomatic or mild; therefore, it is predicted that children who are unaware of their history of COVID-19 before vaccination are not rare. Therefore, after vaccination, extra care should be required to development of MIS-V in children.

Keywords

COVID-19, vaccine, MIS-C, neck pain, dysphagia, adverse event following immunization, child

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

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