Atypical Kawasaki Disease Case Report

Abstract

Kawasaki disease (KD) is a systemic acute vasculitis, characterized by fever, bilateral non-exudative conjunctivitis, redness of the tongue, lips, and oral mucosa, changes in the extremities, cervical lymph node, and polymorphic exanthema. The diagnostic criteria for Kawasaki disease are fever and at least four of the above five symptoms. Aneurysms and stenosis of coronary arteries are the most severe complications. In many cases, the clinical criteria for KD are not all present (incomplete or atypical KD). The particularity of the presented case is given by the initial interpretation of exanthema as an allergy skin rash at Cefuroxime. Arthritis was initially considered reactive or in the Systemic Juvenile Rheumatoid Arthritis, leading to a delay of the positive diagnosis. Appearance in the convalescent phase of desquamation of the fingers took the diagnosis to KD. Treatment with Aspirin was initiated in the 11-day fever. The prognosis of the case is good because there are no cardiac complications.