Article Text

Download PDFPDF
Kawasaki-like multisystem inflammatory syndrome associated with SARS-CoV-2 infection in an adult
  1. Eamonn Faller1,
  2. Rachel Barry2,
  3. Owen O'Flynn3,
  4. Peter Kearney4 and
  5. Corinna Sadlier1,5
  1. 1Department of Infectious Diseases, Cork University Hospital Group, Cork, Ireland
  2. 2Microbiology, Cork University Hospital, Cork, Ireland
  3. 3Department of Medicine, Cork University Hospital, Wilton, Cork
  4. 4Cardiology, Cork University Hospital Group, Cork, Ireland
  5. 5School of medicine, University College Cork, Cork, Ireland
  1. Correspondence to Dr Corinna Sadlier; Corinna.Sadlier{at}


Kawasaki-like hyperinflammatory syndrome has been widely described as a manifestation of SARS-CoV-2 infection in paediatric patients. We report a compatible presentation and suggest that physicians consider the potential for this multisystem inflammatory syndrome to occur in adults. A 23-year-old man presented to hospital with a 4-day history of vomiting, diarrhoea, dry cough, fever and a blanching erythematous rash on hands, feet and buttocks. He was otherwise fit and healthy. On day 3 of admission, marked bilateral conjunctivitis developed and high sensitivity troponin I increased significantly, followed by acute respiratory compromise requiring high-flow nasal oxygen therapy. Transthoracic echocardiogram on day 5 showed severe global hypokinesis of the left ventricle with an ejection fraction of 22%. SARS-CoV-2 was not detected by reverse transcription PCR on nasopharyngeal swabs, sputum or stool samples, however, SARS-CoV-2 antibody was positive. The patient’s syndrome resolved and cardiomyopathy reversed completely with supportive measures. He has since made a good recovery.

  • COVID-19
  • infectious diseases
  • cardiovascular medicine

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Twitter @eamofaller

  • Contributors EF—drafted main article, drafted table. OO’F—provided clinical images, drafted paragraphs, edited, signed off. RB—edited and clarified areas relating to microbiology, finalised. PK—clarified and edited areas relating to cardiology, Finalised/signed off. CS—edited, signed off, clarified in areas relating to infectious disease.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.