Multisystem Inflammatory Syndrome in Children (MIS-C) is a newly recognized multiorgan disease seen in children, adolescent and young adults presumed to be a delayed immune mediated complication of Corona virus 2 (SARS-CoV-2) infection leading to severe acute respiratory syndrome. MIS-C can be associated with life threatening organ dysfunction requiring complex multidisciplinary care. Early recognition is important in order to prevent complication and serious sequalae. Because it is a post infective complication, in most of the cases RT-PCR comes negative though antibodies to COVID-19 are positive. Although SARS-CoV-2 in children are generally mild and nonfatal, there is increasing evidence of MIS-C. Clinical and laboratory features of MIS-C are similar to those of Kawasaki disease like syndrome and Toxic Shock Syndrome. Pathophysiology of MIS-C is still unclear and mainly due to formation of autoantibody and immune complex which activates inflammation. Most of the MIS-C associated with COVID-19, need treatment with ionotropic agents and anticoagulants. The long-term outcome of MIS-C like coronary artery aneurysm formation remain unknown and needs close follow up.

Nutritional deficiency is very common in pediatric patients, especially in developing countries. A 4-year-old Maldivian boy presented with pain in major joints of lower limbs since two months and was unable to stand and walk since one month. There was no history of fever or fall. The growth was average with mild pallor. There was no joint swelling. Xray knee joint showed epiphyseal separation, cortical thinning suggesting a radiological diagnosis of Scurvy and after Vit C supplementation the child showed clinical and radiological improvement in two weeks. So, a high index of suspicion is required for early diagnosis and treatment.