What Is Pediatric Multi-System Inflammatory Syndrome (PMIS)?

Outbreaks are often described as “U” shaped: they are most dangerous to the very young, and to the very old. The coronavirus has been the exception, because its victims have largely been elderly and immunocompromised. Kids, it appeared, were not dying – a small silver lining to an otherwise tragic story.

However, the Centers for Disease Control and Prevention (CDC) has published an emergency health notice about a condition called pediatric multi symptom inflammatory syndrome (PMIS). Children with PMIS experience inflammation in the eyes, skin, heart, and blood vessels, in addition to fever, sluggishness, swollen lymph nodes, rashes, and abdominal pain. Additional symptoms may include swollen lymph nodes in the neck, cracking or redness in the tongue or lips, and redness and swelling in the hands and feet. In some cases, PMIS can lead to organ failure, and a small number of fatalities have been reported.

Pediatric Multi-System Inflammatory Syndrome

The medical community generally believes that PMIS has a relationship to COVID-19, but the complete nature of that relationship is not fully known as of this time. Most of the child patients with PMIS have either tested positive for COVID-19 or have developed antibodies to the disease, which means they were previously infected without manifesting symptoms.

According to Marietta Vázquez, M.D. who is a Yale Medicine pediatric infectious disease specialist, PMIS “seems to be a new manifestation associated with COVID-19. There is much we still don’t know, but it appears to occur in children after they have gotten better from COVID, and it has a lot of similarities to other diseases we see in pediatrics.”

PMIS vs. Kawasaki disease

PMIS has similar characteristics to Kawasaki’s disease which is a serious, but rare, childhood illness without a definitive cause. The most prominent symptom of Kawasaki’s disease is a high fever, usually greater than 102°F, for five or more consecutive days. A Kawasaki disease diagnosis must also include four out of these five symptoms:

  • Enlarged lymph nodes
  • Redness in the soles of the feet and the palms
  • Red eye
  • Rash
  • Changes to the mucous membrane (lining of the mouth and nose)

Kawasaki’s disease left untreated can result in the swelling of blood vessels in the heart, including the critical coronary arteries that feed blood to the heart muscle.

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