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We report a 16-year-old female who presented with seven days of fever, abdominal pain, headache, and fatigue. Physical examination revealed meningeal irritation. Laboratory findings showed pancytopenia, elevated inflammatory markers, and positive SARS-CoV-2 IgG with negative PCR. The patient had no history of COVID-19 vaccination or previous confirmed infection. Initially evaluated as MIS-C due to fever, multisystem involvement, and antibody positivity, she was subsequently diagnosed with visceral leishmaniasis after bone marrow aspiration revealed Leishmania amastigotes. This case highlights the diagnostic overlap between MIS-C and endemic infections such as leishmaniasis and underlines the importance of considering infectious etiologies in hyperinflammatory presentations, especially in endemic areas.<\/jats:p>","DOI":"10.1186\/s12887-025-06451-5","type":"journal-article","created":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T12:59:36Z","timestamp":1765803576000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Rare disease mimicking multisystem inflammatory syndrome in children"],"prefix":"10.1186","volume":"26","author":[{"given":"Asuman","family":"Akar","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,12,15]]},"reference":[{"key":"6451_CR1","doi-asserted-by":"crossref","unstructured":"Dong E, Du H, Gardner L. 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