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Atypical Presentation of Kawasaki Disease With Coronary Artery Aneurysms in a 2.5-Month-Old Infant: A Case Report

Suzan Mahfoud1, Aous Arous2, Danial Antonios2

  • 1Damascus University, Pediatrics Hospital, Tartous, Syria.

Clinical Medicine Insights. Case Reports
|August 8, 2025
PubMed

Insights

Kawasaki disease (KD) in infants presents diagnostic challenges, often mimicking other infections. Early recognition and treatment with IVIG and aspirin are crucial for preventing severe coronary artery complications.

Area of Science:

  • Pediatrics
  • Cardiology
  • Rheumatology

Background:

  • Kawasaki disease (KD) is a critical pediatric illness causing febrile vasculitis in children under five.
  • Coronary artery complications are a significant concern in KD patients.
  • Early diagnosis is vital to prevent long-term cardiovascular sequelae.

Observation:

  • A 2.5-month-old infant presented with a prolonged 15-day fever, initially misdiagnosed.
  • Laboratory findings included leukocytosis, thrombocytosis, and elevated C-reactive protein (CRP).
  • Echocardiography confirmed coronary artery dilation and pericardial effusion, indicative of KD.

Findings:

  • Initial treatment with intravenous immunoglobulin (IVIG) and aspirin resolved the fever.
  • Recurrent symptoms required additional IVIG and corticosteroid therapy.
  • Follow-up imaging revealed persistent coronary artery dilation, highlighting the risk of chronic vascular damage.

Implications:

  • This case highlights the diagnostic difficulties of KD in infants, particularly with atypical presentations.
  • Prompt recognition and management of KD are essential to mitigate severe outcomes like coronary aneurysms.
  • Healthcare providers must consider KD in infants with unexplained prolonged fevers to improve patient prognosis and reduce cardiac risks.

Keywords:
Kawasaki diseaseatypical presentationgiant coronary aneurysminfant

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