An infantile Kawasaki disease presenting with pseudo obstruction

Abstract

Kawasaki disease is a multisystem vasculitis predominantly involving skin and cardiovascular system. In our patient, a 35-day-old female infant presented with fever, abdominal distension, altered sensorium, seizures of 6 days duration. The baby was not responding to conventional antibiotics. Subsequently, she developed rash with vesicles over the perineum and over the palms and soles, edema of hands and feet and fissured lips. The rash appeared 4 days after the onset of systemic symptoms. As per the American Heart Association guidelines for Kawasaki disease, our patient had a fever of 6 days duration and four of the five diagnostic criteria for Kawasaki disease and hence it was a case typical of Kawasaki disease. On investigation, cerebrospinal fluid showed features of aseptic meningitis, urine examination suggested sterile pyuria, with no electrolyte imbalance and no demonstrable foci of infection. Hence, we hereby are presenting a very rare case of Kawasaki disease in a female infant of 35 days; probably the youngest reported so far from India.