Kawasaki disease in an infant: a case report

Abstract

Background: Kawasaki disease is an acute systemic vasculitis of childhood, with a predilection of the main coronary artery. This disease is the most frequent cause of acquired heart disease in developed countries. This report is aimed to describe the diagnosis and treatment of Kawasaki disease in an infant. Case description: A 4-month-old boy came to the emergency room on November 21, 2021, with a chief complaint of high fever for three days. His appetite has decreased since he got sick. Other complaints, such as red eyes, red lips and red rashes overall his body, occurred two days before the admission. Physical examination: the child's nutritional status was good, with bilateral non-purulent conjunctivitis, erythema and cracked lips, and polymorphous rash on the body, back, and legs. We found enlarged cervical lymph nodes and reactivation of Bacillus Calmette-Guerin (BCG) scars. The laboratory findings were as follows: HGB 10.6gr/dL, WBC 11.570/µL, PLT 335.000/µL, CRP 84mg/dL, Antigen NS-1 dengue test negative, and SARS-COV2 Antigen test negative. The echocardiography results were minimal pericardial effusion and normal coronary size. With a Harada score of 4, he was diagnosed with Kawasaki disease. Management of the patient includes breastfeeding, infusion of dextrose 5% with sodium chloride (Na Cl) 0.22%, Paracetamol infusion, Intravenous Immunoglobulin (IVIg) single dose, and Acetylsalicylic acid orally. After being discharged from the hospital, he was advised to control his condition routinely to a pediatrician. Conclusion: Kawasaki disease has been reported in a 4-month-old boy with typical clinical manifestations and successfully treated with good results.