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Acalculous Cholecystitis From Kawasaki Disease in a Three-Month-Old Girl: A Rare Sign at an Uncommon Age

Hansa Sriphongphankul1, Jirayut Jarutach1, Thampapon Chaisujyakorn1

  • 1Department of Pediatrics, Prince of Songkla University, Songkhla, THA.

Cureus
|August 19, 2024
PubMed

Insights

A three-month-old infant with fever and diarrhea was diagnosed with atypical Kawasaki disease (KD). Early treatment with immunoglobulin and aspirin led to rapid recovery, highlighting KD

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Rheumatology

Background:

  • Kawasaki disease (KD) is a rare pediatric vasculitis.
  • Typical KD manifestations are often absent in infants.
  • Acalculous cholecystitis can be an atypical presentation.

Observation:

  • A previously healthy three-month-old girl presented with fever, diarrhea, and abdominal guarding.
  • Initial presentation mimicked bacterial infection, with ultrasonography suggesting acute acalculous cholecystitis.
  • Antibiotic therapy was ineffective.

Findings:

  • Atypical Kawasaki disease was suspected due to persistent symptoms and uncommon age.
  • Diagnosis was confirmed using alternative criteria and echocardiography.
  • Intravenous immunoglobulin G and aspirin initiated on day 9 resulted in rapid clinical improvement.

Implications:

  • This case underscores the importance of considering atypical Kawasaki disease in infants with non-specific febrile illnesses.
  • Prompt diagnosis and treatment are crucial for preventing cardiac complications.
  • Echocardiography and alternative diagnostic criteria aid in managing complex pediatric cases.

Keywords:
acute acalculous cholecystitisatypical kawasaki diseaseincomplete kawasaki diseaseinfantnon-infectious cholecystitis

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