We describe 18 fluorodeoxyglucose positron emission tomography/computed tomography (18FDG-PET-CT) findings in a patient that inadvertently betrayed features of MIS-A. The findings were suggestive of an exaggerated Systemic inflammatory response syndrome (SIRS)- a prequel to MIS-A. MIS-A has been recently described in 2020 as a post-infectious or para-infectious sequela of COVID-19. Within 12 weeks of symptomatic or asymptomatic COVID-19 illness (diagnosed by serum SARS CoV2 antibodies), patients present with an illness requiring hospitalization that can rapidly progress to myocardial dysfunction and cardiogenic shock. (1)
As with any illness, there is a period of ‘quiet before the storm’. Identification of patients early in the course of the illness and prompt treatment can improve clinical outcomes in MIS-A.