An unusual case of incomplete Kawasaki disease in an adolescent returning from holiday in Montana.

Here we present an unusual case of incomplete Kawasaki disease in a 15-year-old boy returning from a holiday with his family in Montana. His symptoms were initial diarrhoea and lethargy, with fever, rash, conjunctivitis, and arthralgia developing during the course of his illness. His condition worsened while he was at his local hospital, and he was transferred to the regional tertiary paediatric hospital. An initial echocardiogram was normal; however, repeat echocardiogram showed dilated coronary arteries with subsequent development of peeling of the skin on the hands and feet. The patient was started on intravenous immunoglobulin and high-dose aspirin and improved clinically. He was discharged home and remains under follow-up by the infectious diseases and cardiology teams.

Postinfectious purpura fulminans secondary to varicella-induced protein S deficiency.

Varicella is usually a benign and self-limited disease of infancy and childhood although it has been recognized that it sometimes has severe and life-threatening complications. We report a case of postinfectious purpura fulminans with acquired protein S deficiency following varicella in a 6-year-old child and discuss the underlying mechanism of postinfectious purpura fulminans.