A Case of Atypical Kawasaki Disease / 소아알레르기및호흡기학회지

ABSTRACT

Kawaski disease is the leading cause of acquired heart disease in children in many parts of the world. Atypical Kawasaki disease does not meet the diagnostic criteria of Kawasaki disease. Incomplete presentations make early diagnosis and timely treatment difficult. Delays in diagnosis and treatment are associated with an increased risk of coronary artery aneurysm. Thus, echocardiography should be considered in febrile infants of uncertain etiology. Clinical practitioners should have a high index of suspicion to diagnose and initiate prompt treatment to reduce the comorbidity of coronary arterial disease in patients with atypical Kawasaki disease. A 9-month-old girl had daily high spiking fever for 9 days and showed erythematous change on BCG vaccination site only. Echocardiography was performed and disclosed saccular aneurysm of left coronary artery and diffuse right coronary artery dilatation. She was treated with intravenous immunoglobulin and aspirin. After 6 months, a follow-up echocardiogram revealed decreased size of coronary arteries. In such cases, careful evaluation of clinical findings with erythematous change on BCG vaccination site are needed.