Ava, a 21-month-old female, presents to her primary care provider’s office with 4 days of fever and a macular rash that started yesterday. The rash began on her face and has spread to the trunk, arms, and legs. Her lips became red and cracked today, and her eyes have been red. Today, she has had minimal oral intake and no urine output. There has been no associated cough, runny nose, vomiting, or diarrhea.

There is no one else currently ill at home. A few weeks ago, her father had COVID-19 but recovered with outpatient management. Ava did not develop any symptoms at that time.

Because of her minimal intake and urine output, her pediatrician sends her to the CHOP ED where she is found to have lymphopenia, thrombocytopenia, hyponatremia, elevated transaminases, and a significantly elevated ESR and CRP.

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