Acute Jaundice in a Six-year-old: An Unusual Presentation of Atypical Kawasaki Disease

Area of Science:

• Pediatrics
• Rheumatology
• Immunology

Background:

• Kawasaki disease (KD) is a critical childhood vasculitis associated with significant morbidity and mortality.
• Early diagnosis and treatment are essential to prevent severe sequelae, particularly cardiac complications.

Observation:

• A six-year-old male presented with jaundice and direct hyperbilirubinemia, initially afebrile in the emergency department.
• The patient subsequently developed fever, rash, and desquamation, meeting criteria for incomplete KD.

Findings:

• The case demonstrates an unusual presentation of incomplete Kawasaki disease with hyperbilirubinemia in a child who was initially afebrile.
• Treatment with intravenous immunoglobulin successfully averted cardiac involvement.

Implications:

• This case underscores the need for heightened clinical suspicion for Kawasaki disease, even in the absence of typical fever at presentation.
• Recognizing atypical presentations of incomplete KD is crucial for timely intervention and improved patient outcomes.