Neck symptoms occur relatively frequently during multisystem inflammatory syndrome in children

(HealthDay)—Neck symptoms are a relatively common manifestation of multisystem inflammatory syndrome in children (MIS-C), according to a brief report published online June 26 in the Journal of the Pediatric Infectious Diseases Society.

Elan Jenkins, M.D., from the Emory University School of Medicine in Atlanta, and colleagues examined the prevalence of neck pain and/or associated symptoms among MIS-C patients diagnosed between March 2020 and Jan. 20, 2021, at Children's Healthcare of Atlanta. Using manual chart abstraction of the electronic medical record, demographic, clinical, laboratory, treatment, and outcome data were obtained.

The researchers identified 137 MIS-C cases, of which 28.5 percent had neck-related symptoms. Thirty-eight of these 39 patients had neck pain; three had trismus; and five had drooling, dysphagia, or difficulty swallowing. Neck imaging was performed on 12 unique patients and included computed tomography (CT; eight patients), ultrasound (two patients), magnetic resonance imaging (MRI; one patient), and/or plain radiography (two patients). Patients with neck pain were older (10 versus 8 years) and were more likely to have undergone lumbar puncture. Four patients with neck imaging by CT or MRI had evidence of retropharyngeal edema/inflammation. The patients with retropharyngeal edema were all aged 13 years or older. Among these patients, each received five days or more of antibiotic treatment, and two received 10 days of antimicrobials.

"Otolaryngologic manifestations may be under-recognized clinical features of MIS-C that do not fall clearly into the organ system criterion in the current U.S. Centers for Disease Control and Prevention case definition," the authors write.