Abstract

Multisystem inflammatory syndrome in children (MIS-C) is one of several severe complications of COVID-19 seen in children. The United States Center for Disease Control diagnostic guidelines for MIS-C include age <21 years, 24-hour history of fever ≥38.0ºC, severe illness necessitating hospitalization, two or more organ system involvement, laboratory evidence of inflammation, laboratory or epidemiologic evidence of SARS-CoV-2, and a lack of alternative diagnosis. This case report focuses on one patient who met six out of the seven cardinal features of MIS-C but fell outside the average age range. Unfortunately, the patient died from complications of COVID-19. Since our patient had multiple risk factors, including obesity and Hispanic ethnicity the pathogenesis of the disease occurring in our patient was likely identical to that which occurs in MIS-C. Due to a significant chance of mortality in patients with MIS-C and COVID-19, it is important to consider this diagnosis in older adolescents and young adults. This patient’s unfortunate outcome urges prompt greater suspicion for this rare and life-threatening complication, even though this patient is older than the typical MIS-C patient.