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Kawasaki disease: always straight to the heart?

Henning Clausen1, Claire Howarth, Alessandro Giardini

  • 1Department of Cardiology, Great Ormond Street Hospital for Children, London, UK. h.clausen@doctors.org.uk

BMJ Case Reports
|August 28, 2012
PubMed

Insights

Kawasaki disease, a vasculitic illness, can cause hearing loss in children, even with atypical symptoms. Early diagnosis is key to prevent lasting complications like hearing impairment.

Area of Science:

  • Pediatric Rheumatology
  • Vascular Inflammation
  • Childhood Illnesses

Background:

  • Kawasaki disease is a critical consideration for prolonged fever in children.
  • Early diagnosis and treatment are vital to prevent serious vascular complications, particularly coronary artery aneurysms.
  • Atypical presentations of Kawasaki disease pose diagnostic challenges.

Observation:

  • This case report details a 6-year-old boy with complex congenital heart disease who presented with atypical Kawasaki disease.
  • The child experienced profound acute hearing loss as a primary manifestation.
  • Coronary artery abnormalities were not evident in early follow-up assessments.

Findings:

  • The patient's hearing loss necessitated the use of bilateral hearing aids.
  • Atypical symptomatology in Kawasaki disease can include significant sensorineural deficits.
  • Congenital heart disease can complicate the diagnostic picture of Kawasaki disease.

Implications:

  • Healthcare providers should consider Kawasaki disease even with unusual symptoms and in complex pediatric cardiac cases.
  • Prompt recognition of atypical Kawasaki disease can mitigate severe long-term sequelae, such as permanent hearing loss.
  • This case underscores the importance of a broad differential diagnosis in pediatric fever evaluations.

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