Multisystem inflammatory syndrome-children is considered as a paediatric hyper inflammatory condition prompted by severe acute respiratory system coronavirus 2, which has multi-organ involvement. Among them cervical lymphadenopathy is an unusual presentation in multisystem inflammatory syndrome-children. A case study of 17 year old post coronavirus disease 2019 male patient, whose clinical presentation and elevated inflammatory markers on blood tests lead to the diagnosis of multisystem inflammatory syndrome-children is explained here. Evidence from computed tomography, ultrasonography and fine needle aspiration cytology revealed the rare presentation of multisystem inflammatory syndrome-children with cervical lymphadenopathy. Standard guidelines were followed in the treatment of the condition and the prognosis was closely monitored clinically, the available objective evidences manifested progressive response and outcome.

A 49-year-old male who is a RT recipient since 2020, came with dyspnea and fever is a known case of insulin-dependent T2DM. The patient was on immunosuppression with tacrolimus, mycophenolate mofetil and prednisolone and RT-PCR tested positive. In view of COVID-19 infection mycophenolate mofetil dose was reduced and prednisolone dose (10 mg) was increased to 15 mg, other medications include cotrimoxazole, aspirin-atorvastatin, silodosin, rabeprazole-domperidone, metoprolol, cilnidipine and insulin. On day 10, the rapid antigen test detection turned negative and the patient did not experience any other complaints. Hence mycophenolate mofetil dose was increased, tacrolimus dose was adjusted based on tac level and prednisolone dose was tapered to 10 mg OD. The patient was symptomatically improved and discharged on day 12. Case 2A 50-year-old male who had live donor RT on 2017 with history of T2DM and HTN, presented to hospital with headache and fever. His treatment included tacrolimus, mycophenolate mofetil and prednisolone. He was diagnosed with COVID-19 infection on October 27. Mycophenolate mofetil was stopped and the rest continued. Further management included azithromycin 500 mg OD, calcium-vitamin D3 500 mg BD, zinc acetate 50 mg OD and heparin 5000 IU. His chest X-ray detected bilateral pulmonary infiltration. Oxygen saturation improved to 95% with 4 litres oxygen from 86%. On day 11, he tested negative for SARS-COV-2 and transferred to ward on day 12. Case 3A 56 years old male RT recipient (2010) with the history of T2DM and diabetic ketoacidosis since 20 years was shifted to our hospital on day 10