Introduction
Coronavirus disease 2019 (COVID-19) was thought to largely spare
children until clinicians in the United Kingdom reported a cluster of
children with fever and hyperinflammation in late April
20201. Similar reports from Italy, France, and the
United States led the Centers for Disease Prevention and Control (CDC)
to define this illness as Multisystem Inflammatory Syndrome in children
(MIS-C) (CDC). The case definition of MIS-C includes the presence of
fever, laboratory evidence of inflammation, multisystem organ
involvement, and evidence of SARS-CoV-2 infection or an epidemiologic
link to a person with COVID-192. The broad case
definition and wide spectrum of clinical presentations, observed with
MIS-C, coupled with lack of pathognomonic signs and diagnostic tests
have posed new challenges in the evaluation of children presenting with
fever and elevated inflammatory markers due to the risk of serious and
life-threatening illnesses that must be considered in these patients.
In this report, we describe six patients admitted to the hospital with
concerns for MIS-C who were later diagnosed with EVALI.