Pediatr Infect Vaccine.  2017 Apr;24(1):60-64. 10.14776/piv.2017.24.1.60.

Acute Scrotum in an Infant with Kawasaki Disease

• Kang HY
• Joo EY
• Kim DH
• Hong YJ

• KMID: 2390883
• DOI: http://doi.org/10.14776/piv.2017.24.1.60

Abstract

Kawasaki disease (KD) is a systemic vasculitis that occurs predominantly in infants and young children. The etiology of KD is unknown and coronary heart disease is a major complication of KD. Acute scrotum is a rare complication of acute KD, and not as well recognized as other manifestations of the disease. We report a 2-month-old boy with acute scrotum in the acute phase of KD. He was treated with intravenous immunoglobulin (total 2 g/kg) and aspirin (50 mg/kg/day). The treatment was effective in resolving his fever and other clinical symptoms, but 2 days after starting treatment he experienced scrotal swelling. Scrotal ultrasound and transillumination were used in the diagnosis of acute scrotum. After 2 months, a follow-up testicular ultrasound revealed a remission of the acute scrotum. Subsequently, he has been followed up for KD.

Keyword

Mucocutaneous lymph node syndrome; Testicular hydrocele; Urological manifestations

MeSH Terms

Aspirin
Child
Coronary Disease
Diagnosis
Fever
Follow-Up Studies
Humans
Immunoglobulins
Infant*
Male
Mucocutaneous Lymph Node Syndrome*
Scrotum*
Systemic Vasculitis
Testicular Hydrocele
Transillumination
Ultrasonography
Urological Manifestations
Aspirin
Immunoglobulins

Figure

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  Fig. 1 Clinical course of patient. Abbreviations: IVIG, intravenous immunoglobulin; iv, intravenous.

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  Fig. 2 Both scrotal swelling appeared on day 7. The swelling and crust were more severe in the left side.

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  Fig. 3 Transverse gray-scale ultrasound image of the testicle showed bilateral complex fluid collection with internal echogenic materials in the right scrotal sac and multiple septations in the left scrotal sac. The image also demonstrated bilateral scrotal wall thickening with increased vascularity.

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