Suspected Mast Cell Activation Mimicking Heart Failure Exacerbation and Abdominal-Wall Cellulitis in a Resource-Limited Setting: A Case Report

Abstract

This case highlights that acute mast-cell-mediated reactions may mimic heart failure exacerbation and cellulitis, particularly when cutaneous, respiratory, and gastrointestinal manifestations occur together after a potential trigger. In low-resource settings, careful exclusion of infection and true cardiogenic worsening, combined with close assessment of therapeutic response, may help guide management. However, in the absence of recurrent episodes and confirmatory mediator testing, a definitive diagnosis of MCAS should be made cautiously.