Multisystem inflammatory syndrome in children (MIS-C) is a hyperinflammatory
disease that occurs after infection with severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2). We report a 9-month-old male infant with two
episodes of hyperinflammatory disease, each involving the coronary arteries,
within a short period of time during the SARS-CoV-2 pandemic. Although
both episodes met the official criteria for MIS-C, this case illustrates the
difficulty in distinguishing MIS-C from its main differential diagnosis, Kawasaki
disease (KD). Recurrence of postviral hyperinflammatory disease is rare.
Compared with KD, the recurrence of MIS-C is even rarer, but clinicians
should be aware of this possibility. Our case also emphasizes the need to
follow up these patients closely and to detect sequelae regularly, especially
cardiovascular sequelae, at an early stage.