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An atypical presentation of atypical Kawasaki disease

Brit L Anderson1, Amy B Guiot, Nathan L Timm

  • 1From the *Division of Emergency Medicine and †Department of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.

Pediatric Emergency Care
|July 3, 2014
PubMed

Insights

Kawasaki disease (KD) can be challenging to diagnose, even with classic symptoms. This case highlights how atypical presentations, like limping and incontinence, can mask KD, emphasizing the need for vigilance in diagnosing incomplete forms.

Area of Science:

  • Pediatrics
  • Cardiology
  • Rheumatology

Background:

  • Kawasaki disease (KD) is a leading cause of acquired heart disease in children.
  • Diagnosis can be challenging, particularly in cases with atypical or incomplete presentations.
  • Early recognition and treatment are crucial to prevent coronary artery abnormalities.

Observation:

  • A 3-year-old girl presented with a limp and urinary incontinence, unusual symptoms for Kawasaki disease.
  • Initial presentation did not meet the classic diagnostic criteria for KD.
  • Further investigation revealed a large coronary artery aneurysm on echocardiogram.

Findings:

  • The patient was ultimately diagnosed with Kawasaki disease.
  • The case illustrates the diagnostic difficulties posed by incomplete KD presentations.
  • Coronary artery aneurysm formation was a significant finding, underscoring the severity of the condition.

Implications:

  • This case underscores the importance of considering Kawasaki disease in children with nonspecific symptoms.
  • It highlights the challenges in diagnosing incomplete KD and the potential for severe cardiac complications.
  • Increased awareness and diagnostic vigilance are necessary for timely intervention in pediatric inflammatory disorders.

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