Kawasaki-like syndrome occurring in children during the COVID-19 pandemic has been labelled multisystem inflammatory syndrome in children (MIS-C) by the CDC and paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 infection (PIMS-TS) by the ECDC. We report the case of an 18-year-old male patient presenting with a 72-hour history of abdominal pain, fever, erythematous skin rash, vomiting and diarrhoea. Examination showed he also had shock and he was first thought to have oedematous cholecystitis. SARS-CoV-2 infection was also diagnosed. SB225002 concentration He was admitted to the ICU, and echocardiography showed cardiac dysfunction, with a low ejection fraction and low cardiac index. High-sensitivity troponin serum levels were elevated. The patient received inotropic and vasopressor support. As he fulfilled several criteria for MIS-C/PIMS-TS, he was administered acetylsalicylic acid, corticosteroids and immunoglobulin, with a good clinical response. This case emphasizes how this severe presentation of COVID-19 can easily be misdiagnosed if the clinician is less aware of this syndrome in younger patients. SARS-CoV-2 infection is a diagnostic challenge in some patients with atypical clinical presentations, who may have MIS-C/PIMS-TS.Physicians should be aware of this condition when evaluating teenagers and young adults with COVID-19.SARS-CoV-2 infection is a diagnostic challenge in some patients with atypical clinical presentations, who may have MIS-C/PIMS-TS.Physicians should be aware of this condition when evaluating teenagers and young adults with COVID-19.Segmental arterial mediolysis (SAM) is a non-inflammatory, non-atherosclerotic vasculopathy mostly involving the abdominal arteries. SAM was recently recognized as a more prevalent aetiology of abdominal pain than initially thought by healthcare providers. It is still a commonly missed diagnosis in patients with recurrent emergency room (ER) visits for abdominal pain. Most published case reports in the past have highlighted catastrophic sequelae such as intra-abdominal haemorrhage requiring surgical intervention. We report a case of SAM where the diagnosis was initially missed. After diagnosis, conservative medical management was offered which led to clinical improvement. To recognize segmental arterial mediolysis (SAM) as a cause of chronic abdominal pain in the middle-aged and elderly population.To differentiate SAM from inflammatory vasculitis and atherosclerotic conditions.For cases with mild symptoms and haemodynamic stability, conservative management such as early lifestyle modifications, hypertension and hyperlipidaemia control and regular imaging follow-up should be offered.To recognize segmental arterial mediolysis (SAM) as a cause of chronic abdominal pain in the middle-aged and elderly population.To differentiate SAM from inflammatory vasculitis and atherosclerotic conditions.For cases with mild symptoms and haemodynamic stability, conservative management such as early lifestyle modifications, hypertension and hyperlipidaemia control and regular imaging follow-up should be offered.Hypoglycaemia is rare in apparently well patients without drug-treated diabetes mellitus and warrants evaluation and management when Whipple's triad is present. Even in the absence of Whipple's triad, when repeatedly low values of plasma glucose are documented, the presence of endogenous hyperinsulinism should be investigated. The authors describe a case of endogenous hypoglycaemic hyperinsulinism, its diagnosis and treatment and the challenges of determining its aetiology. A high degree of suspicion is necessary when a hospitalized, apparently well, patient presents with episodes of hypoglycaemia with no apparent cause.Documented repeated low glucose values (<40-55 mg/dl) warrant investigation even when Whipple's triad is absent.The diagnosis, approach and treatment of endogenous hypoglycaemic hyperinsulinism is challenging and requires persistence, particularly if examinations fail to show the responsible lesion.A high degree of suspicion is necessary when a hospitalized, apparently well, patient presents with episodes of hypoglycaemia with no apparent cause.Documented repeated low glucose values ( less then 40-55 mg/dl) warrant investigation even when Whipple's triad is absent.The diagnosis, approach and treatment of endogenous hypoglycaemic hyperinsulinism is challenging and requires persistence, particularly if examinations fail to show the responsible lesion.Toxic shock syndrome (TSS) is a rare inflammatory response syndrome associated with an infection by toxigenic strains of Staphylococcus aureus or group A β-haemolytic Streptococcus. We report a rare case of menstrual TSS associated with usage of a menstrual cup. The diagnosis was established through case definition criteria and supported by vaginal cultural growth of Staphylococcus aureus with evidence of TSS toxin 1 (TSST-1). The patient received prophylactic intravaginal clindamycin in an individual approach to reduce the risk of recurrence. No relapse was reported in the 12 months following discharge. TSS should be considered in female patients presenting with fever, rash, hypotension and current menses. Prompt initiation of antibiotics and supportive care is critical.Menstrual cups may be a rare cause of TSS.Prophylactic antibiotic therapy may reduce the risk of relapse.TSS should be considered in female patients presenting with fever, rash, hypotension and current menses. Prompt initiation of antibiotics and supportive care is critical.Menstrual cups may be a rare cause of TSS.Prophylactic antibiotic therapy may reduce the risk of relapse. Recurrent deliberate sharp foreign body ingestion is associated with frequent hospitalizations and a high risk of complications, including perforation and peritonitis. These patients require urgent care. In addition, removal of foreign bodies can be challenging. We describe the case of a patient with borderline personality disorder who was admitted multiple times with sharps ingestion and presented challenges with her care. Our case highlights the cause of recurrent sharps ingestion and provides recommendations on the retrieval of sharp foreign bodies and prevention. Recurrent sharps ingestion is associated with psychiatric illness.Ingested sharps can cause perforation and peritonitis, so urgent care is required.A multidisciplinary approach is necessary to care for these patients and prevent sharps ingestion in future.Recurrent sharps ingestion is associated with psychiatric illness.Ingested sharps can cause perforation and peritonitis, so urgent care is required.A multidisciplinary approach is necessary to care for these patients and prevent sharps ingestion in future.