This clinical observation is an example to show the complexity of diagnosing and treating children with SARS-CoV-2-associated multisystem inflammatory syndrome. A 17-year-old patient who had a mild form of COVID-19 two weeks ago had a fever again and felt severe abdominal pain, and his general condition deteriorated rapidly. Moreover, on the fifth day from the onset of the disease, a child from the district hospital was admitted to the Ivano-Matreninsky Childrens Hospital in critical condition. Due to peritoneal symptoms, a diagnostic laparoscopy was performed to exclude acute surgical diseases which revealed mesadenitis and hydroperitoneum. Subsequently, the patient had a prolonged fever, severe multiple organ failure developed, including myocarditis with damage to the conduction system of the heart and a marked decrease in the left ventricular ejection fraction, bilateral pneumonia, hydroperitoneum and hydrothorax, acute kidney injury, lymphopenia, thrombocytopenia, coagulopathy, increased markers of inflammation. Non-invasive artificial lung ventilation was performed for 3 d. On day 10, an atrial temporary pacing system was installed, removed 11 d after heart rhythm normalization, and the pleural cavity was drained due to spontaneous pneumothorax. There was a gradual positive trend in respiratory status, the state of the cardiovascular system, normalization of laboratory parameters, and a decrease in inflammation markers. The patient was discharged from the hospital in a satisfactory condition on day 39. This clinical case demonstrates a severe course of childhood inflammatory, multisystem syndrome with multiple organ failure. The peculiarities of the case include the severity of abdominal pain syndrome, requiring laparoscopy, impaired cardiac activity, and requiring a pacemaker for 11 days.

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1 ФГБОУ ВО «Астраханский ГМУ» Минздрава России, г. Астрахань, Россия; 2 ФГБУ «НИИ пульмонологии» ФМБА России, г. Москва, Россия В статье приведен клинический пример развития сепация-синдрома у больной муковисцидозом и подробно изложена 4-месячная терапия, которая неоднократно корректировалась в зависимости от состояния пациентки. Ключевые слова: муковисцидоз, дети, Burkholderia cepacia сomplex, сепация-синдром Ответственный за переписку: Сергиенко Диана Фикретовна -д.м.н., профессор кафедры факультетской педиатрии, ФГБОУ ВО «Астраханский государственный медицинский университет» Минздрава России, г. Астрахань,

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