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Severe Kawasaki disease in a 3-month-old patient: a case report
Salvatore Leonardi1, Patrizia Barone, Giacomo Gravina
1Unit of Broncho-Pneumology and Cystic Fibrosis, Department of Medical and Pediatric Science, University of Catania, Via Santa Sofia 78, Catania 95123, Italy. leonardi@unict.it.
Insights
Kawasaki disease in infants under 3 months is rare and severe, often presenting atypically. Early coronary artery aneurysms can develop despite prompt treatment, highlighting diagnostic challenges in young infants.
Area of Science:
- Pediatric Vasculitis
- Infant Cardiology
Background:
- Kawasaki disease is a multi-system vasculitis affecting children under 5.
- Rare in infants <3 months, often atypical and treatment-resistant.
- Increases risk of coronary artery aneurysms.
Observation:
- A 3-month-old infant presented with early, severe coronary artery aneurysms.
- Treatment included intravenous immunoglobulins and methylprednisolone.
- The infant's condition was unresponsive to therapy.
Findings:
- Delayed diagnosis and treatment correlate with coronary artery aneurysm development.
- Atypical or incomplete Kawasaki disease forms pose challenges.
- Very young infants (<3 months) face increased severity and poorer outcomes.
Implications:
- Highlights the need for heightened awareness of Kawasaki disease in very young infants.
- Emphasizes the risk of severe cardiovascular complications, including coronary aneurysms.
- Underscores treatment challenges and potential unresponsiveness in this age group.
Background:
Kawasaki disease is a multi-system vasculitis which usually occurs in children under 5 years of age. In infants under three months of age, it is very rare and usually associated with a high incidence of incomplete or atypical forms, often unresponsive to treatment. This condition increases the risk of cardiovascular complications such as coronary artery aneurysms.
Case Presentation:
We describe a 3-month-old infant who developed early and severe aneurysms in three coronary arteries despite a timely administration of intravenous immunoglobulins, followed by three days of intravenous methylprednisolone.
Conclusion:
This case report underlines that the development of coronary artery aneurysm correlates with a delayed diagnosis and treatment, incomplete or atypical forms of the disease, and additionally the severity of clinical presentation, especially in cases of very young infants below 3 months of age. Our case is notable because of the very young age of the patient, the severity of clinical presentation with an early development of coronary artery aneurysms and the unresponsiveness to the therapy.
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