Refractory Kawasaki Disease Presenting With Erythema at Bacille Calmette-Guérin Inoculation Site: A Paediatric Case Report

Abstract

Kawasaki disease (KD) is an autoimmune disease that generally affects children under the age of five years. It has a variety of clinical manifestations which may be either specific or nonspecific. Intravenous immunoglobulin and aspirin are the mainstays of treatment. There are unusual circumstances where patients are resistant to conventional treatment. We report a one-year-old girl who presented with a 12day history of fever in association with erythema at the site of Bacille Calmette-Guérin (BCG) scar. She did not respond successfully to conventional treatment although she was diagnosed to have Kawasaki disease. Eventually, she responded to intravenous methylprednisolone and was diagnosed as having refractory Kawasaki disease.

Multiresistant Kawasaki Disease in a Young Infant with Giant Aneurysms Growing Fast

“…Coronary artery aneurysms (CAAs) develop in up to 25% of untreated cases [4], but giant CAAs are rare [5]. Early treatment with intravenous immunoglobulin (IVIg) decreases the incidence of CAAs to 5-7% [6]; nevertheless, 10-20% are refractory to treatment [7]. Treatment delay, age of less than one year, and refractory disease have shown to be associated with CAAs development [8].…”