{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T03:28:08Z","timestamp":1762054088583,"version":"build-2065373602"},"reference-count":20,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,6,6]],"date-time":"2022-06-06T00:00:00Z","timestamp":1654473600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infectious Disease Reports"],"abstract":"<jats:p>Multisystem inflammatory syndrome in children (MIS-C) may develop as a rare complication following COVID-19. MIS-C presentation varies substantially, but fever and gastrointestinal symptoms are the most prominent. Indeed, gastrointestinal involvement may be severe enough to present as acute abdomen, posing challenges to clinicians. We present herein the case of a healthy five-year-old male who presented with fever, vomiting, and abdominal pain, resembling acute abdomen. The patient had no history of SARS-CoV-2 infection or exposure, and MIS-C diagnosis was initially surpassed unnoticed. The patient underwent exploratory laparotomy that only revealed mesenteric lymphadenitis. Postoperatively, the patient met the clinical and laboratory diagnostic criteria of MIS-C. SARS-CoV-2 exposure was serologically confirmed and MIS-C treatment was commenced, resulting in defervescence and a satisfactory outcome. In young patients presenting with acute abdomen, surgeons should be aware of MIS-C, so that earlier diagnosis and appropriate treatment are made prior to surgical interventions.<\/jats:p>","DOI":"10.3390\/idr14030046","type":"journal-article","created":{"date-parts":[[2022,6,6]],"date-time":"2022-06-06T10:08:24Z","timestamp":1654510104000},"page":"428-432","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Mesenteric Lymphadenitis Presenting as Acute Abdomen in a Child with Multisystem Inflammatory Syndrome"],"prefix":"10.3390","volume":"14","author":[{"given":"Evangelos","family":"Blevrakis","sequence":"first","affiliation":[{"name":"Department of Paediatric Surgery, School of Medicine, University of Crete, 715 00 Heraklion, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4026-0328","authenticated-orcid":false,"given":"Eleni","family":"Vergadi","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Medical School, University of Crete, 715 00 Heraklion, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Stefanaki","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, School of Medicine, University of Crete, 715 00 Heraklion, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iris","family":"Alexiadi-Oikonomou","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, School of Medicine, University of Crete, 715 00 Heraklion, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8079-8117","authenticated-orcid":false,"given":"Glykeria","family":"Rouva","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Medical School, University of Crete, 715 00 Heraklion, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioannis","family":"Germanakis","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Medical School, University of Crete, 715 00 Heraklion, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanouil","family":"Galanakis","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Medical School, University of Crete, 715 00 Heraklion, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"102573","DOI":"10.1016\/j.amjoto.2020.102573","article-title":"Pediatric COVID-19: Systematic review of the literature","volume":"41","author":"Patel","year":"2020","journal-title":"Am. J. Otolaryngol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1111\/apa.15270","article-title":"Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults","volume":"109","author":"Ludvigsson","year":"2020","journal-title":"Acta Paediatr."},{"key":"ref_3","first-page":"365","article-title":"Diagnosis and management of kawasaki disease","volume":"91","author":"Saguil","year":"2015","journal-title":"Am. Fam. Physician"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Nakra, N.A., Blumberg, D.A., Herrera-Guerra, A., and Lakshminrusimha, S. (2020). Multi-System Inflammatory Syndrome in Children (MIS-C) Following SARS-CoV-2 Infection: Review of Clinical Presentation, Hypothetical Pathogenesis, and Proposed Management. Children, 7.","DOI":"10.3390\/children7070069"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1056\/NEJMoa2021680","article-title":"Multisystem Inflammatory Syndrome in U.S. Children and Adolescents","volume":"383","author":"Feldstein","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.ajem.2021.05.076","article-title":"Multisystem inflammatory syndrome in children with COVID-19","volume":"49","author":"Gottlieb","year":"2021","journal-title":"Am. J. Emerg. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1111\/apa.16178","article-title":"Acute abdomen in multisystem inflammatory syndrome in children: A systematic review","volume":"111","author":"Rouva","year":"2022","journal-title":"Acta Paediatr."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"5619","DOI":"10.1172\/JCI143840","article-title":"Immune pathogenesis of COVID-19-related multisystem inflammatory syndrome in children","volume":"130","author":"Rowley","year":"2020","journal-title":"J. Clin. Invest."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"25254","DOI":"10.1073\/pnas.2010722117","article-title":"Superantigenic character of an insert unique to SARS-CoV-2 spike supported by skewed TCR repertoire in patients with hyperinflammation","volume":"117","author":"Cheng","year":"2020","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"100527","DOI":"10.1016\/j.eclinm.2020.100527","article-title":"Multisystem inflammatory syndrome in children: A systematic review","volume":"26","author":"Ahmed","year":"2020","journal-title":"EClinicalMedicine"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1001\/jamapediatrics.2021.0630","article-title":"Trends in Geographic and Temporal Distribution of US Children with Multisystem Inflammatory Syndrome during the COVID-19 Pandemic","volume":"175","author":"Belay","year":"2021","journal-title":"JAMA Pediatr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"101913","DOI":"10.1016\/j.epsc.2021.101913","article-title":"COVID-19-associated multisystem inflammatory syndrome in children (MIS-C) presenting as appendicitis with shock","volume":"71","author":"Anderson","year":"2021","journal-title":"J. Pediatr. Surg. Case Rep."},{"key":"ref_13","first-page":"e20200","article-title":"Multisystem Inflammatory Syndrome Presenting as Early Acute Appendicitis","volume":"13","author":"Anderson","year":"2021","journal-title":"Cureus"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1111\/1744-1633.12526","article-title":"Acute appendicitis during the clinical course of COVID-19 in a 13-year-old boy: Complication or coincidental?","volume":"25","author":"Nurullayev","year":"2021","journal-title":"Surg. Pract."},{"key":"ref_15","first-page":"e15893","article-title":"Acute Appendicitis Associated with Multisystem Inflammatory Syndrome in Children","volume":"13","author":"Hofto","year":"2021","journal-title":"Cureus"},{"key":"ref_16","first-page":"479","article-title":"Acute appendicitis in children with multisystemic inflammatory syndrome associated to SARS-CoV-2 (MIS-C). A complication to consider","volume":"95","year":"2021","journal-title":"An. Pediatr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"101604","DOI":"10.1016\/j.epsc.2020.101604","article-title":"Intestinal ischemia secondary to Covid-19","volume":"61","author":"Khesrani","year":"2020","journal-title":"J. Pediatr. Surg. Case Rep."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"95","DOI":"10.2478\/prilozi-2021-0027","article-title":"A Case of Multisystem Inflammatory Syndrome in Children Presenting as Acute Appendicitis and Pancreatitis","volume":"42","author":"Kareva","year":"2021","journal-title":"Prilozi"},{"key":"ref_19","first-page":"e15600","article-title":"A Case of COVID-19 Mimicking Acute Appendicitis in Multi-System Inflammatory Syndrome","volume":"13","author":"Martin","year":"2021","journal-title":"Cureus"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"101512","DOI":"10.1016\/j.epsc.2020.101512","article-title":"Non-operative management of acute appendicitis in a pediatric patient with concomitant COVID-19 infection","volume":"59","author":"Jones","year":"2020","journal-title":"J. Pediatr. Surg. Case Rep."}],"container-title":["Infectious Disease Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2036-7449\/14\/3\/46\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:24:54Z","timestamp":1760138694000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2036-7449\/14\/3\/46"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,6]]},"references-count":20,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,6]]}},"alternative-id":["idr14030046"],"URL":"https:\/\/doi.org\/10.3390\/idr14030046","relation":{},"ISSN":["2036-7449"],"issn-type":[{"type":"electronic","value":"2036-7449"}],"subject":[],"published":{"date-parts":[[2022,6,6]]}}}