Kawasaki's disease with paralytic ileus. A case report

The authors report on an 18 month-old boy affected by Kawasaki's disease (KD). The diagnosis of KD was made after exclusion of conditions with similar presentation. Two days after admission the child presented vomiting, abdominal distension, meteorism and increase of scrotal swelling with edema. An abdominal X-ray showed the presence of multiple water and gas levels in the ileum and subsequent diagnosis of paralitic ileus was made. After several evacuative enema the intestinal symptomatology resolved. The patient was treated twice (2 g/kg day and after 3 days again 2 g/kg day) with intravenous immunoglobulin following which he made an uneventful recovery. The authors conclude that the presence of paralytic ileus in a febrile child may represent an unusual clinical sign of KD and justify a timely commencement of intravenous immuno-globulin therapy.