Multisystem Inflammatory Syndrome in Children (MIS-C) presents with fever, fatigue, elevated inflammatory markers (acute phase reactants), and a history of exposure to SARS-CoV-2 or positive antibodies to SARS-CoV-2. As the COVID-19 pandemic unfolded, the risk of MIS-C in the pediatric population increased. However, exposure to other viruses and the presence of SARS-CoV-2 positive antibodies in children hospitalized for various pathogen-associated illnesses will also remain common and may complicate differential diagnoses with diseases endemic to the region such as rickettsial diseases. The objective was to highlight the desirability of medical personnel systematically incorporating rickettsiosis as a differential diagnosis for MIS-C when studying a child with fever, non-specific symptoms, and elevated inflammatory markers. In conclusion MIS-C should be considered in children with elevated inflammatory markers when there is a history of COVID-19 and they also meet criteria that have already been established by international agencies, such as CDC and WHO

中文翻译：

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尤卡坦半岛梅里达市诊断为小儿多系统炎症综合征的住院儿童中的立克次体和伤寒立克次体

儿童多系统炎症综合征 (MIS-C) 表现为发烧、疲劳、炎症标记物（急性期反应物）升高，以及 SARS-CoV-2 接触史或 SARS-CoV-2 抗体阳性。随着 COVID-19 大流行的展开，儿科人群中 MIS-C 的风险增加。然而，因各种病原体相关疾病而住院的儿童接触其他病毒以及 SARS-CoV-2 阳性抗体的存在也仍然很常见，并且可能使该地区流行疾病（例如立克次体病）的鉴别诊断复杂化。目的是强调医务人员在研究发烧、非特异性症状和炎症标志物升高的儿童时，系统地将立克次体病作为 MIS-C 的鉴别诊断的必要性。总之，对于有 COVID-19 病史且炎症标志物升高的儿童，应考虑 MIS-C，并且这些儿童也符合 CDC 和 WHO 等国际机构已经制定的标准