ABSTRACT
We present a rare association of Kawasaki disease in a two year old boy presenting with fever, a morbiliform rash and clinical signs of intestinal pseudo-obstruction. Our patient subsequently developed a giant aneurysm of the right coronary artery complicated with thrombosis. He presented fever again 48 hours after the first dose of Immunoglobulin and needed a second one with good results. These patients with giant coronary aneurysms have a greater risk of developing stenosis and myocardial infarction, and require anticoagulant therapy, frequent stress scans and coronary angiographies. Those who develope less severe disease need only antiplatelet therapy and less frequent cardiovascular tests. Patients with a normal echocardiogram after the acute phase of the disease are not treated. The long-term prognosis of this disease in uncertain, especially regarding the possible association with coronary disease in adult life.
Subject(s)
Humans , Male , Child, Preschool , Coronary Aneurysm , Intestinal Obstruction , Mucocutaneous Lymph Node SyndromeABSTRACT
We present a rare association of atypical Kawasaki disease and intussusception in a three month old male patient. it all began with high fever and an obstructive intestinal syndrome developed in the second day of hospitalization, diagnosed as a colo-colonic intussusception. Despite an adecuate postoperative antibiotic coverage the high fever continued, which made us pursue a diagnosis of a vasculitis syndrome among other entities. The echocardiogram showed dilatation of both coronary arteries. The currenty accepted clinical criteria for Kawasaki disease may not always allow its identification in patients who are younger than six months of age. A diagnosis of Kawasaki disease and an echocardiographic evaluation of the coronary arteries should be considered in young infants with prolongued fever of unkown origin. (Rev Med Hered 2001; 12: 37-41).