Multisystem inflammatory syndrome in adults (MIS-A), is a rare post-infectious complication of COVID-19. We describe an illustrative case of MIS-A in an otherwise well, SARS-CoV-2 unvaccinated 25-year-old Tongan man who presented to hospital 30 days after mild COVID-19 illness. We highlight the progression of his illness, including treatment in the Intensive Care Unit (ICU) for cardiogenic shock, and detail temporal evolution of clinical, laboratory and radiographic features of his illness. Clinicians should be alert for possible MIS-A in the weeks after a surge in COVID-19 cases.
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