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An Interesting Case of Refractory Kawasaki Disease With Co-infection

Ratan Kumar1, Adyasha Mishra2, Kumar Diwakar3

  • 1Pediatric Intensive Care Unit, Tata Main Hospital, Jamshedpur , IND.

Cureus
|July 8, 2024
PubMed

Insights

Kawasaki disease (KD) is a childhood vasculitis. This case shows refractory KD can coexist with infection, requiring combined IVIG, antibiotics, and corticosteroids for treatment.

Area of Science:

  • Pediatric Rheumatology
  • Infectious Diseases

Background:

  • Kawasaki disease (KD), a childhood vasculitis, requires timely diagnosis and treatment.
  • Early treatment aims to prevent coronary artery abnormalities.

Observation:

  • A 3-year-old girl presented with persistent fever fulfilling KD criteria.
  • Initial treatment with IVIG and aspirin was ineffective.
  • Klebsiella pneumoniae infection was identified via urine culture.

Findings:

  • Refractory KD was diagnosed due to persistent fever.
  • Treatment was escalated with a repeat IVIG dose, oral corticosteroid, and antibiotics.
  • The patient showed clinical improvement after the intensified treatment.

Implications:

  • This case underscores the importance of considering concurrent infections in refractory KD.
  • Combined immunosuppressive and antimicrobial therapy may be necessary for complex cases.
  • Highlights the potential for infection to complicate Kawasaki disease management.

Keywords:
co-infectionimmunoglobulinivigkawasaki diseaserefractory kawasaki diseaseuti

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