Myositis in Kawasaki disease

Myositis is recognized as one of several neurologic complications encountered in Kawasaki disease. We report an unusual patient with Kawasaki disease which was complicated by severe myositis and respiratory failure secondary to weakness. Comparison of our patient with previously reported cases leads us to conclude that myositis in Kawasaki disease usually is present within 1-3 weeks of illness; the symptoms usually are mild and probably remain unnoticed by most physicians, but weakness can be severe and respiratory failure may occur. The degree of creatine kinase elevation may be useful in predicting the severity of myopathy and in alerting the physician to the need for close respiratory monitoring. Therapy is supportive and complete recovery is to be expected.