PMC9458478_01
Chest X-ray of the patient showing massive right side pleural effusion. A Pleural effusion after the third day of pleurocentesis on the first presentation. B Reappearance of pleural effusion 4 weeks after first presentation
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Fig1
Urgent pigtail insertion in the right pleural space was done with drainage of 4 l of pleural fluid (Fig. 1A) and replacement with IV albumin 20% (5 cc/kg). Right side pleural effusion recollected again (Fig. 1B) associated with worsening hypoxia.
Chest CT of the patient. A At admission on the first presentation. B after 3 days of appearance of respiratory manifestations
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Fig2
It was suggestive of viral pneumonia mostly COVID-19 (COVID-19-Reporting and Data System (CO-RADS) V) (Fig. 2).
Skin lesions in the patient with MIS-C. Multiple skin lesions appeared in the form of petechiae (D) and ecchymotic patches (A &C) one of them shows ulceration (B)
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Fig3
On the 4th week, multiple skin lesions appeared in the form of vasculitic rash, petechiae, and ecchymotic patches (one of them showed ulceration) (Fig. 3).
Flow chart showing the progression of the case
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Fig4
The patient returned to isolation where progressive deterioration of the respiratory, liver, kidney, and cardiac functions occurred until he passed away after 1 month of admission (Fig. 4).