A Case of COVID-19 Related Myasthenic Crisis: Lessons Learned

Abstract

Background: COVID-19 was initially described to affect the respiratory system, it is now known to affect other systems and present in a myriad of ways. This has often proved to be a diagnostic and therapeutic challenge to clinicians and stretched healthcare resources, sometimes with poor outcomes. We report on an atypical presentation of SARS-CoV-2 infection as an acute exacerbation of myasthenia gravis in a low resource setting. Case Presentation: A middle aged male with myasthenia gravis presented with a three weeks’ history of worsening generalized weakness and three days’ history of new-onset dysphagia with no history of fever and cough. After a few days of apparent improvement, the patient developed progressive respiratory distress. Further evaluation confirmed bilateral pneumonia and COVID-19. Conclusion: There is a need for clinicians and health service providers to have a low threshold for suspicion and testing for COVID-19 in patients with pre-existing medical conditions and immunomodulatory therapy such as Myasthenia gravis.