Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2025 Feb 7;87(4):2377-2381.
doi: 10.1097/MS9.0000000000002995. eCollection 2025 Apr.

Unraveling the complexity in diagnosis and management of multisystem inflammatory syndrome in children with Kawasaki disease mimicry: a case report

Abdus Samad Ansari  1 , Dhiraj Chaurasia  1 , Sagar Kafle  2
Affiliations
Case Reports

Unraveling the complexity in diagnosis and management of multisystem inflammatory syndrome in children with Kawasaki disease mimicry: a case report

Abdus Samad Ansari et al. Ann Med Surg (Lond). .

Abstract

Introduction and importance: COVID-19 can lead to a severe complication in children known as multisystem inflammatory syndrome (MISC), often mimicking Kawasaki disease (KD). This study addresses the diagnostic challenges and management of MISC.

Case presentation: A 6-year-old female presented with fever, vomiting and rash. Clinical examination revealed cervical lymphadenopathy, periungual desquamation, lip fissures and abdominal tenderness. Echocardiography showed RCA dilatation. These findings suggested multisystem involvement and fulfilled the criteria of typical KD. The treatment was started accordingly with IVIG and empirical antibiotics. However, the confirmation of presence of SARS-CoV-2 antibody led to substantial shift of diagnosis to MISC Despite initial treatment, fever persisted, thus, Intravenous steroid was started which led to significant clinical improvement, rendering her almost asymptomatic in 2 weeks.

Clinical discussion: Distinguishing MISC from KD is critical. Diagnostic criteria, epidemiology, and lab markers play a vital role. The case underscores the importance of recognizing subtle differences for accurate diagnosis and effective management.

Conclusion: MISC, resembling KD, poses diagnostic complexities. This case emphasizes the need for clinicians to consider MISC in children with persistent fever and multisystem involvement post-COVID-19 exposure. Timely diagnosis and intervention are paramount for favorable outcomes in this emerging pediatric condition, urging increased awareness and reporting among healthcare professionals.

Keywords: Kawasaki disease; case report; multisystem inflammatory syndrome in children (MISC).

PubMed Disclaimer

Conflict of interest statement

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. The authors declare no conflicts of interest.

Figures

Figure 1.
Figure 1.
Chest X ray (AP view).
Figure 2.
Figure 2.
Electrocardiography (ECG) of the patient.
See this image and copyright information in PMC

References

    1. Payne AB, Gilani Z, Godfred-Cato S, et al. . Incidence of multisystem inflammatory syndrome in children among US persons infected with SARS-CoV-2. JAMA Netw Open 2021;4:e2116420. - PMC - PubMed
    1. Moodley P, Tsitsi JML, Reddy DL, et al. . A case of multisystem inflammatory syndrome in an african adolescent male: case report. Pan Afr Med J 2021;38. doi:10.11604/pamj.2021.38.174.27910. - DOI - PMC - PubMed
    1. Sohrabi C, Mathew G, Maria N, et al. . The SCARE 2023 guideline: updating consensus Surgical CAse REport (SCARE) guidelines. Int J Surg 2023;109:1136–40. - PMC - PubMed
    1. Kawasaki Syndrome 1990. Case Definition | CDC. Accessed November 17, 2023. https://ndc.services.cdc.gov/case-definitions/kawasaki-syndrome-1990/
    1. Listings of WHO’s response to COVID-19. Accessed November 14, 2023. https://www.who.int/news/item/29-06-2020-covidtimeline

Publication types

LinkOut - more resources