Pediatr Allergy Respir Dis.  2005 Sep;15(3):311-315.

A Case of Atypical Kawasaki Disease

• Lee JS
• Yoon KL
• Park YM

Abstract

Kawaski disease is the leading cause of acquired heart disease in children in many parts of the world. Atypical Kawasaki disease does not meet the diagnostic criteria of Kawasaki disease. Incomplete presentations make early diagnosis and timely treatment difficult. Delays in diagnosis and treatment are associated with an increased risk of coronary artery aneurysm. Thus, echocardiography should be considered in febrile infants of uncertain etiology. Clinical practitioners should have a high index of suspicion to diagnose and initiate prompt treatment to reduce the comorbidity of coronary arterial disease in patients with atypical Kawasaki disease. A 9-month-old girl had daily high spiking fever for 9 days and showed erythematous change on BCG vaccination site only. Echocardiography was performed and disclosed saccular aneurysm of left coronary artery and diffuse right coronary artery dilatation. She was treated with intravenous immunoglobulin and aspirin. After 6 months, a follow-up echocardiogram revealed decreased size of coronary arteries. In such cases, careful evaluation of clinical findings with erythematous change on BCG vaccination site are needed.

Keyword

Atypical Kawasaki disease; BCG vaccine; Infant; Fever

MeSH Terms

Aneurysm
Aspirin
BCG Vaccine
Child
Comorbidity
Coronary Vessels
Diagnosis
Dilatation
Early Diagnosis
Echocardiography
Female
Fever
Follow-Up Studies
Heart Diseases
Humans
Immunoglobulins
Infant
Mucocutaneous Lymph Node Syndrome*
Mycobacterium bovis
Vaccination
Aspirin
BCG Vaccine
Immunoglobulins