a pediatric case of leptospirosis developed after covid-19 associated multisystem inflammatory syndrome

While presentations of novel severe acute respiratory syndrome coronavirus 2 (sarscov-2) were observed to be mild in children, multi-system inflammatory syndrome in children (mis-c) has emerged as one of the most critical phenomena in the era of coronavirus disease 2019 (covid-19). we present an eight-year-old boy with prolonged fever, weakness, myalgia, arthralgia, oliguria, hematuria, hemoptysis, and periumbilical pain. with regards to the history of contact with sars-cov-2 four weeks prior to symptom onset and prominent gastrointestinal symptoms, mis-c was highly suspected. furthermore, based on the compatible symptoms and history of white-water rafting and exposure to contaminated soil two weeks prior to admission, leptospirosis was probable. of note, leptospirosis immunoglobulin m and covid-19 immunoglobulin g were detectable. lifesaving supportive measures, empirical antibiotic therapy, remdesivir, dexamethasone, and prednisolone pulse therapy were prescribed. afterward, gradual clinical improvement was shown. we aimed to report a case with mis-c accompanied by severe leptospirosis to emphasize that in endemic areas of leptospirosis, considering the co-occurrence of mis-c and other inflammatory disorders is crucial for multidisciplinary management.