2024 Volume 14 Issue 1 Pages 56-61
We report a severe case of coronavirus disease 2019 (COVID-19)-related multisystem inflammatory syndrome in children (MIS-C). A 9-year-old girl who was diagnosed with acute abdomen by appendicitis underwent appendectomy. During anesthetic induction, unexpected hypotension occurred, and she required continuous noradrenaline administration. Pathological examination showed nonspecific findings. She showed KD-like findings such as indurative edema of the extremities, conjunctivitis, and cervical lymphadenopathy on admission. Owing to a history of COVID-19 1 month prior to admission, she was suspected to have MIS-C and treated with intravenous immunoglobulin and methylprednisolone therapy. A variety of symptoms have been reported in MIS-C cases, and in our case acute abdomen and shock were seen at onset. Thus, we need to consider MIS-C as a differential diagnosis when there is a history of COVID-19 with prolonged fever and abdominal symptoms.