Incomplete and atypical presentation of kawasaki disease: a report of five cases

Kawasaki disease [KD] is an acute febrile vasculitis mainly affecting children, with two types of presentation, namely, typical and atypical. It is the most critical cause of coronary artery complications and if not treated on time and appropriately, complications may occur in up to 25% of the patients will get. This study reports five rare cases of incomplete KD Who has been admitted with diagnosis of Bacterial Meningitis, Staphylococcal Septic Arthritis, Herpetic Gingivostomatitis, Viral Hepatitis and prolonged Fever. Since there was no response to treatment, with impression of Atypical Kawasaki patient has been evaluated and treated. Atypical presentation of the disease led to misdiagnosis and prolonged process of diagnosis. Due to the increasing number of atypical Kawasaki cases and the probability of coronary artery disorder, it is recommended that atypical Kawasaki be considered in the differential diagnosis of the disease in the patients with fever of over five days without any clinical cause

[Evaluating the clinical and paraclinical aspects of Kawasaki patients referred to Bandar-Abbas children hospital during 2008-2011]

Kawasaki disease [KD], a systemic vasculitis of unknown etiology with an increasing incidence in childhood, can be the leading cause of the acquired heart diseases. This study aimed to describe the demographics and clinical features of KD patients referred to Bandar-Abbas children hospital. This descriptive case series study was performed on 83 KD patients referred to Bandar-Abbas children hospital during 2008-2011. Diagnostic criteria were fever, skin rash, bilateral noninfectious conjunctivitis, erythema and desquamation of extremities and alterations in the mouth and pharyngeal mucosa. Age, sex, clinical and paraclinical changes of the patients as well as the seasonal prevalence of the disease were evaluated. Among 83 cases, 60 [72.3%] were male and 23 [27.7%] female and. The age range was from 3 months to 13 years. The KD disease occurred more frequently in spring and winter. Fever was seen in 100%, extremity involvement in 54.1% [45], conjunctivitis in 46.1% [39], skin rash in 55.4% [46], and neck lymphadenopathy in 25.3% [21] of the cases. Moreover, the laboratory findings included leukocytosis in 80%, thrombocytosis in 43.6%, abnormal ESR in 73.6% and cardiac sequelae in 11% of the cases. To prevent cardiac sequelae of KD disease, diagnostic work up is suggested in children with prolonged fever unresponsive to antibiotics