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[Febrile torticollis: an atypical presentation of Kawasaki disease]

C Runel-Belliard1, S Lasserre, B Quinet

  • 1Service des urgences et maladies infectieuses pédiatriques, centre de la drépanocytose, hôpital d'enfants Armand-Trousseau, 26, avenue du Docteur-Arnold-Netter, 75012 Paris, France. camille.runel@trs.aphp.fr

Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie
|December 30, 2008
PubMed

Insights

Kawasaki disease, a rare vasculitis, can present atypically. Early diagnosis of this condition, even with symptoms like febrile torticollis, is crucial for preventing severe cardiac complications.

Area of Science:

  • Pediatrics
  • Rheumatology
  • Immunology

Background:

  • Kawasaki disease is an idiopathic systemic vasculitis primarily affecting children.
  • Diagnosis relies on specific clinical criteria, but atypical presentations can cause delays.
  • Cardiac manifestations are a major cause of mortality and morbidity.

Observation:

  • A 4-year-old girl presented with febrile torticollis, an unusual initial symptom.
  • This presentation masked the underlying diagnosis of Kawasaki disease.
  • The case highlights the challenges in diagnosing atypical Kawasaki disease.

Findings:

  • The patient was diagnosed with Kawasaki disease with arthritis.
  • Febrile torticollis was identified as an atypical early sign.
  • A literature review confirmed torticollis as a potential indicator of atypical Kawasaki disease.

Implications:

  • Early recognition of atypical signs like torticollis is vital for prompt diagnosis.
  • Timely treatment with intravenous immunoglobulin can mitigate cardiac sequelae.
  • This case underscores the importance of considering Kawasaki disease in children with unexplained fever and torticollis.

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