Multisystem inflammatory syndrome (MIS) in adults involves severe complications, which include cardiovascular, cerebrovascular, and neural systems, in response to viral infections or vaccines. Clinicians may miss the diagnosis of MIS during the early manifestations of the disease as it can mimic other disorders with similar symptoms. In this report, we describe a MIS-like clinical picture before COVID-19 in a 32-year-old woman, who visited a hospital in southern India as an outpatient with the presenting complaints of swellings in her fingers as well as severe pain in her lower limbs, following a brief spell of viral fever. She was initially diagnosed with reactive sacroiliitis and soon after with myositis. After about two months, she was admitted to the hospital as an in-patient with a chief complaint of shortness of breath. She developed dilated cardiomyopathy, congestive heart failure, and stroke. Brain imaging revealed an increased left middle cerebral artery infarct, increased midline shift, and right basal ganglia bleed. Soon after, she underwent a decompressive craniectomy and was assisted by mechanical ventilation. She became unresponsive and comatose. The patient was discharged from the hospital at the family’s request and was provided home care for over 2 months, during which she continued to be in a deep coma, developed bedsores over the body and gangrene of her lower limbs and eventually died. This case highlights the necessity of intense monitoring and assessments that should lead to early and accurate diagnosis, coupled with concurrent and prophylactic treatments to avoid fatal complications due to disease cascades following an MIS-like clinical syndrome.