ABSTRACT
This is a case report about an 8-year old boy who presented with complaints of fever for 5 days, loose stools, abdominal pain, and erythema of the palms and soles for 3 days. There was a history of short duration fever in all his family members 1 month back, but none of them were tested for COVID-19. On admission, the patient was febrile and had erythematous extremities. There was no organomegaly. He presented with hypotensive shock which was managed with fluid boluses and inotrope support. Fever workup including cultures were negative. His COVID-19 antibody was positive (16.17 index units). Inflammatory markers were elevated: ESR=50 mm/h=;C reactive protein=51 mg/dL;ferritin=>1000 ng/mL;D dimer=8260 ng/mL. Echocardiogram was normal and he was managed with intravenous immunoglobulin due to meeting the criteria for multisystem inflammatory syndrome (MISC) in children. The patient's fever subsided within 48 hours and his inflammatory markers showed declining trend. On the third day of becoming afebrile, the child complained of swelling, pain, and redness of right scrotum. There was no recurrence of fever, nor parotid swelling associated with orchitis. On examination, the right testis was enlarged, tender, located in the normal anatomic position with an intact ipsilateral cremasteric reflex. testicular tension was ruled out by ultrasound doppler. The unilateral orchitis was managed with supportive measures and subsided by 48 hours.