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A 17-year-old girl presented with a painful submandibular lymph node for 7 days, fever (up to 40°C) and asthenia for 5 days. She had no medical history and was not taking any medication. Vital signs were blood pressure 95/68 mm Hg, pulse 118 bpm, oxygen saturation 96% on room air. Physical examination showed a submandibular lymph node, bilateral conjunctivitis, palmoplantar erythrosis (figures 1 and 2) as well as a strawberry tongue (figure 3). Labs showed C-reactive protein at 338.7 mg/dL and white cell count at 11 720/µL (90% neutrophils). ECG demonstrated sinus tachycardia. Chest X-ray was normal and SARS-CoV-2 nasopharyngeal swab PCR was negative.
What is the most likely diagnosis?
Multisystem inflammatory …
Contributors Every author contributed equally to this paper.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting or dissemination plans of this research.
Provenance and peer review Not commissioned; internally peer reviewed.