Paediatric Inflammatory Multisystem Syndrome (PIMS-TS) following SARS-CoV-2 Infection: Diagnosis and Management

(Perth Children’s Hospital) PIMS-TS [also known as Multisystem Inflammatory Syndrome in Children associated with COVID-19 (MIS-C)] is a rare but severe complication that occurred in around 1 in 3000 children 2-6 weeks following infection with previously circulating variants of SARS-CoV-2.¹ Observed PIMS-TS incidence has been lower following Omicron infection compared with earlier waves.^{2, 3}Consider PIMS-TS in the differential diagnosis in children presenting with fever, rash, conjunctival injection, abdominal pain, vomiting/diarrhoea, or shock if they have had proven or suspected COVID-19 in the 2 – 6 weeks prior. Some features overlap with Kawasaki disease, toxic shock syndrome and sepsis.¹Clinical condition can deteriorate rapidly; early recognition and timely initiation of appropriate therapy is important.Most cases of PIMS-TS occur in previously healthy children over the age of 5 years. Vaccinated children are significantly less likely to develop PIMS-TS.^{4, 5}