Kawasaki disease shock syndrome with pulmonary involvement in a child: a case report

Kawasaki disease (KD) is an acute systemic vasculitis that can affect multiple organs. Kawasaki disease shock syndrome (KDSS) is a severe complication of KD. Pulmonary involvement is uncommon in KD, and there are very few reports of patients with KD who develop KDSS and pulmonary lesions. This report presents the case of a 9-year-old boy who was hospitalized for fever, neck mass and rash, and was subsequently diagnosed with KDSS. During the administration of intravenous immunoglobulin (IVIG), he experienced acute dyspnea, which required urgent invasive mechanical ventilation and bronchoscopy. He was successfully weaned off ventilation shortly and recovered completely. No coronary dilatation or pulmonary fibrosis was detected at the 1-month post-discharge follow-up. This case suggests that KD can trigger rare but severe complications including KDSS and pulmonary involvement. The relationship between pulmonary complications, transfusion-related acute lung injury (TRALI) and transfusion-associated circulatory overload (TACO) remains to be further elucidated. Early aggressive management and comprehensive treatment may improve prognosis.