Multisystem Inflammatory Syndrome In Children (MIS-C) with Seropositivity for Scrub Typhus and Leptosipra: A Case Report

Abstract

Multisystem inflammatory syndrome in children (MIS-C) is rare phenomenon that presents after corona virus disease 2019 (COVID-19). According to The Centres for Disease Control and Prevention, one important criterion in diagnosing MIS-C is to exclude other obvious microbiological causes. An 11-year-old boy presented with septic shock, elevated inflammatory markers and multisystem dysfunction. He had antibodies to SARS-CoV-2, Scrub typhus and Leptospira. The patient was initially treated with antibiotics, and other supportive treatments. Patient clinically improved before confirmation of MIS-C thus immunoglobulin and steroid therapy was not instituted. Diagnostic criteria of MIS-C includes absence of other alternative plausible diagnoses but in an endemic area for tropical febrile illness like Nepal, there is the possibility that MIS-C can co-exist with other infectious condition. Therefore there is need of re-evaluation of diagnostic criteria of MIS-C.