Atipical kawasaki disease with coronary aneurysm in infant

Abstract

Kawasaki disease is an acute febrile disease of unknown etiology, characterized by systemic vascular inflammation involving the small and medium sized arteries, with a predilection for the coronary arteries. It represents the leading cause of acquired heart diseases in children in developed countries. Diagnosis, difficult because of the clinical characteristics of the disease with typical signs and symptoms appearing sequentially and not simultaneously, may be even more complicated in case of unusual presentation, leading to delay in recognition, particularly in infant in whom a higher incidence of coronary arteries aneurysms has been reported. A high index of suspicion of Kawasaki disease must be maintained in case of prolonged fever in these patients. Timely appropriate treatment is essential to avoid severe sequels. We report the case of a 2 months old male infant with persistent febrile episode, transferred to us from another institution, who presented on echocardiography giant aneurysms on both coronary arteries.

Erythema multiforme as first sign of incomplete Kawasaki disease

“…Kawasaki disease is an acute, self-limited vasculitis of unknown etiology with a predilection for the involvement of coronary arteries, that affects predominantly infants and young children [1,2]. The diagnosis is based on the presence of fever associated with other transient typical signs, that rarely are simultaneously present at the time of first observation, but can appear subsequently.…”

Late Onset Sepsis and Incomplete Kawasaki Disease in a 3-Month-Old Infant: A Case Report and Literature Review

“…However the use of specific fever duration as a rigid criterion has often been questioned especially in recent years, since the functional and structural cardiac changes can now be more readily assessed due to easy availability of echocardiogram. There are documented case reports where infants developed florid symptoms and complications of KD in absence of fever or after an initial favorable response to antibiotics as evidenced by resolution of fever [8][9][10]. More importantly, the first guidelines were published by Dr. Kawasaki before cardiac involvement was recognized in this disease, and hence they were never intended to identify children at risk for developing coronary artery abnormalities.…”

Ulinastatin, a Urinary Trypsin Inhibitor, for the Initial Treatment of Patients With Kawasaki Disease

“…Our results cannot be generalized to these patients, although physicians may have concern for the management of their care. 43 …”