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Atypical Kawasaki disease presenting with macroscopic hematuria in an infant: a case report

V Thadchanamoorthy1, Kavinda Dayasiri2, I R Ragunathan3

  • 1Faculty of Health Care Sciences, Eastern University, Chenkalady, Sri Lanka.

Journal of Medical Case Reports
|January 10, 2023
PubMed

Insights

Atypical Kawasaki disease can present with unusual symptoms like gross hematuria in young children. Early recognition and treatment are crucial to prevent coronary artery abnormalities.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Cardiology

Background:

  • Kawasaki disease is a critical pediatric illness causing fever and potential coronary artery issues.
  • Diagnosis relies on clinical criteria, but atypical presentations challenge identification.
  • Atypical Kawasaki disease encompasses unusual symptoms in infants lacking classic diagnostic features.

Observation:

  • A 9-month-old boy presented with prolonged fever, lymphadenopathy, rash, and sterile gross hematuria.
  • Elevated inflammatory markers and left coronary artery dilatation were noted on echocardiogram.
  • The child met criteria for incomplete Kawasaki disease after excluding other diagnoses.

Findings:

  • The case highlights sterile gross hematuria as an unusual presenting symptom of atypical Kawasaki disease.
  • High inflammatory markers and coronary artery dilatation indicate significant systemic inflammation.
  • Prompt treatment with intravenous immunoglobulin and aspirin led to a positive clinical response.

Implications:

  • Kawasaki disease should be considered in the differential diagnosis of prolonged fever of unknown origin in young children.
  • Recognizing atypical Kawasaki disease, especially with symptoms like hematuria, is vital for timely intervention.
  • Delayed treatment increases the risk of severe cardiovascular complications, underscoring the need for high clinical suspicion.
Abstract

Keywords:
Atypical KDMaculopapular rashProlonged fever

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