Multisystem inflammatory syndrome in children (MIS-C) with secondary intestinal cytomegalovirus infection: A case report.

Abstract

Multisystem inflammatory syndrome in children (MIS-C) constitutes a severe pediatric disorder temporally linked to SARS-CoV-2 infection. Although SARS-CoV-2 may induce cytomegalovirus (CMV) reactivation, MIS-C cases with secondary intestinal CMV infection are exceptionally rare. We describe a pediatric patient with MIS-C treated initially with intravenous immunoglobulin (IVIG) and methylprednisolone, following clinical improvement, sudden high fever and worsening abdominal symptoms occurred. Symptomatic resolution occurred following ganciclovir administration, with CMV infection confirmed by colonic histopathology and metagenomic next-generation sequencing (mNGS).