Long-term Fever Research Articles

Diagnostic search for long-term fever states

By terms «protracted subfebrilitet» and «fever of unknown genesis lasted» (FUGL) mark situations which quite often arise up in clinical practice, at which a fervescence is the basic or unique sign of different diseases the diagnosis of which remains unknown after a leadthrough ordinary, and in a number of cases and additional inspection. The spectrum of diseases which are underlaid protracted subfebrilitet and FUGL is wide enough and includes different illnesses of infectious nature, malignant tumours, system vasculitis, and also other various after the origin diseases. Protracted fever ordinary diseases are underlaid with unusual motion. Diagnostic search under these conditions requires identification of additional clinical and laboratory features, which determine the features of a focused examination of patients using the most informative for a concrete situation diagnostic methods. Question about the advisability of treatment, including testing, to decrypt of protracted subfebrilitet and FUGL must decide individually, depending on the specific clinical situation.

Association of Prenatal Maternal Fever and Neonatal Umbilical Artery Blood-Gas Analysis: Evidence from a Tertiary Center at China

Background: Neonatal umbilical artery blood-gas analysis is a diagnostic procedure performed shortly after birth to assess the acid-base balance, oxygenation, and metabolic status of a newborn infant. This retrospective study aimed to investigate the association of prenatal maternal fever with neonatal umbilical artery blood-gas analysis. Methods: A retrospective analysis was conducted on data from 333 parturients and their newborns. Demographic characteristics, clinical information, and neonatal umbilical artery blood gas analysis data were analyzed to evaluate the association between prenatal maternal fever and neonatal blood-gas analysis. Pregnant women with fever (≥38.0 °C) during labor were compared with those without fever. Neonatal umbilical artery blood gas parameters were assessed in relation to the degree and duration of maternal fever. Results: The incidence of the adverse delivery outcome of parturients with high prenatal fever and long duration of fever was significantly higher than that of the low fever, short-term fever, and normal parturients (p < 0.05). The pH of neonatal umbilical veins in the high fever groups was reduced compared with the control group (p < 0.05). Lactic acid (Lac) of neonatal umbilical vein in the low fever and high fever groups was enhanced compared with the control group (p < 0.05). The pH of neonatal umbilical veins in the short-term fever and long-term fever groups was elevated compared with the control group (p < 0.05). The umbilical artery pH and base excess (BE) were positively correlated with maternal peak fever temperature (r = 0.20, r = 0.22, p < 0.05). The umbilical Lac was negatively correlated with maternal peak fever temperature (r = –0.22, p < 0.05). Moreover, the umbilical artery pH and BE were positively correlated with maternal duration of fever (r = 0.29, r = 0.21, p < 0.05). The umbilical artery Lac was negatively correlated with maternal duration of fever (r = –0.25, p < 0.05). Conclusions: The findings suggested that maternal fever during labor was associated with alterations in neonatal umbilical artery blood gas analysis. Understanding the influence of prenatal fever on delivery outcomes is crucial for optimizing maternal and neonatal health.

Identification of the Diversity of Medicinal Plants Used by Battra in North Bengkulu

All kinds of plants that are found in nature and have medicinal properties are considered medicinal plants. Utilization of medicinal plants can be used directly and mixed. Battra is a person who has knowledge of traditional medicine and is capable of concocting medicinal plants. North Bengkulu is one of the districts that still use conventional medical care. Utilizing medicinal plants that are proven to be able to treat those derived from natural ingredients can be healthful because of very few side effects compared to drugs that contain chemicals. The goal of the study was to catalog the various medicinal herbs used by Battra North Bengkulu. This study used 10 respondents' interviews as its approach. Battra uses 64 species from 37 families of medicinal plants as traditional medicinal ingredients. The most common type of family is Fabaceae. The habitus group that is widely used is 45% trees. Types of diseases that are commonly treated traditionally using these plants include fever, toothache, itching, cramps, internal heat, scales, stomach pain, malaria, long-term fever, colds (cholera), ulcers, lungs, kidney stones, jaundice, high blood pressure, appendicitis, fussy children, eye disease, intestinal worms, kesapo, sprains, tumors and gout. In the processing of medicinal plants by Battra in North Bengkulu, 11 processes the highest drug processing method was by boiling as much as 37%.

Sarcoidosis revealed by long-term fever at the Vierzon Hospital: About a case and literature review

Sarcoidosis is a systemic disease mainly affecting the mediastinum and the lungs. The other manifestations are much rarer and lead to diagnostic and therapeutic wanderings. The present study reports a case of lymph node sarcoidosis revealed by a long-lasting fever. The diagnosis is based on clinical and paraclinical arguments and the elimination of other causes of lymphadenopathy. The evolution is favorable after 6 months of corticosteroid therapy.

Kikuchi Disease in Elderly: Report of a Rare Disease in an Unusual Age

Kikuchi disease is a benign, self-limited, and rare condition presented mainly by lymphadenopathy and fever. Kikuchi disease is more common in women, especially women under 40. We report a 63-year-old Iranian woman presenting with long-term fever, constitutional symptoms, and cervical lymphadenopathy. A lymph node biopsy was done for her, and the diagnosis of Kikuchi disease was confirmed. Kikuchi disease is a self-limited condition with a good prognosis that can resolve with no specific treatment within a few weeks. Still, some patients are at risk of recurrence and development of SLE and Lymphoma. Our patient was treated with a low dose of glucocorticoids. On 6 month follow-up, she had no signs and symptoms of recurrence and no evidence of SLE development. The interesting point of this case is the clinical picture and her age of presentation.

Children suspected of having intracranial infection with normal brain magnetic resonance imaging may be associated with the myelin oligodendrocyte glycoprotein antibody

PurposeTo confirm whether encephalitis due to unknown causes but with normal brain magnetic resonance imaging (MRI) may be associated with the myelin oligodendrocyte glycoprotein (MOG) antibody. MethodsWe retrospectively analyzed and summarized the characteristics of three patients initially suspected of having intracranial infections with normal brain MRI, and ultimately tested positive for anti-MOG antibody. ResultsThe three patients mainly presented with long-term fever accompanied by headaches and drowsiness. Auxiliary examinations showed obvious leukocytosis in peripheral blood and leukocytosis and increased protein expression in cerebrospinal fluid (CSF); furthermore, brain MRI was normal. These findings suggested intracranial infection, especially bacterial meningitis. No patient showed a response to prolonged anti-bacterial therapy; however, they recovered with glucocorticoid therapy, which was prescribed after anti-MOG antibodies were detected in the serum and CSF samples. ConclusionAnti-MOG antibody detection should be performed early for patients with suspected encephalitis due to unknown causes with normal brain MRI, to identify whether they have MOG antibody-associated diseases (MOGAD).

БОЛЕЗНЬ СТИЛЛА. СЛУЧАЙ В ПРАКТИКЕ УРОЛОГА

This article shows the peculiarity of the course and difficulties of diagnosing Still's disease in adults. Still disease is a rare multisystemic inflammatory disease of unknown nature. The incidence of Still's disease is 0.1—0.4 cases per 100 thousand population. Therefore, each case of the disease is of significant interest to doctors of various specialties. The article presents patient B. at the age of 20, who entered a urological hospital with long-term fever, signs of systemic inflammatory response syndrome, suspected kidney carbuncle. The patient underwent a comprehensive examination. As a result of the examination, the diagnosis of kidney carbuncle was excluded and the presence of Still's disease in adults was confirmed. After intensive care, persistent remission of the disease was achieved. This clinical case have demonstrated peculiarities of the course and diagnostic of patient with Still's disease.

HIV Infection in Patients Aged Over 50 in the Infectious Diseases Unit at Brazzaville University Hospital: Prevalence and Associated Factors

Objective: The prevalence of HIV infection in people aged is of significant importance. We determined the prevalence of HIV infection with patients aged over 50 at the Brazzaville University Hospital and look for its associated factors. Patients and Method: Cases of HIV infection in patients over 50 years admitted to the Infectious Diseases Unit of Brazzaville University Hospital were examined under cross-sectional descriptive and analytical study. This survey concerns the period going from January 1, 2019 to June 30, 2021. Results: There were one hundred and ninety-four patients (8.2% of admissions). Their mean age was 57.40 ± 6.4 years [50-93], they were mostly female (n = 113; 58.2%). The most dominant population was the age group between 50-59 years (n = 136; 70.1%). They were single people (n = 80; 41.2%), without profession (n = 87; 44.8%), with a primary education level (n = 81; 41.8%), hypertensive (n = 27; 13.9%), diabetics (n = 15; 7.7%). HIV infection was discovered during hospitalization (n = 111; 57.2%), for deterioration of the general condition (n = 72; 37.1%), long-term fever (n = 56; 28.9%), chronic cough (n = 40; 20.6%). The patients were at WHO stage 3 (n = 133; 68.6%). The mean CD4 were 188.5 ± 11.7 / mm3 [19-433]. In 172 cases (88.7%), the patients had two sexual partners and did not use a condom (n = 189; 97.4%). The main opportunistic infections were tuberculosis (n = 74; 18.1%) and cerebral toxoplasmosis (n = 48; 24.7%). ART was made with the combination of TDF + FTC + EFV (n = 79; 40.7%). The observation was poor in 33% (n = 64) and unfavourable outcome in 47.4% (n = 92). These were IRIS (n = 5; 2.6%) and death (n = 85; 43.8%), due to anaemic shock (n = 17; 20%), septic shock (n = 8; 9.4%). Marital status (P = 0.04), WHO stage (p = 0.02), and non-compliance treatment (p = 0.0001) could have the link with the death patients. Conclusion: HIV infection in people over 50 years is relatively common at Brazzaville University Hospital, especially among single women. The lethality remains high, unrelated to an opportunistic infection but rather with the notion of non-compliance with treatment and the advanced stage of HIV infection according to the WHO classification. This shows the interest in raising awareness among this population for early detection and the treatment of HIV.

Infectious Endocarditis with Major Cutaneous Expression: About A Case

Introduction: Infectious endocarditis is a transplant of microorganisms in healthy endocardium, in injured endocardium or intracardiac material. The modes of revelation can be multiple and varied, the skin manifestations of an infectious although classical endocarditis, are rare. Observation: This was a young 20-year-old patient, admitted in our cardiac unit for the exploration of a cardiac murmur in a context of long-term fever evolving for nearly 3 weeks associated with a skin rash. The examination found fever at 39°C and tachycardia at 115 beats/min. The cardiac auscultation revealed tachycardia with a systolic breath apexian mitral insufficiency. The skin examination revealed Osler’s nodules, an erythema of Janeway on the soles of the feet and on the palms of the hands. In biology, there was a non-specific biological inflammatory syndrome. Blood cultures from three series of samples did not isolate a germ. The transthoracic echography showed large vegetations in the anterior and posterior leaflets of mitral valve associated with severe mitral regurgitation. In this context, the diagnosis of mitral endocarditis is retained according to the Duke criteria. A double intravenous antibiotic therapy based on ceftriaxone and gentamycin was administrated. The evolution was favorable with stable apyrexia, disappearance of skin signs, regression of non-specific biological inflammatory syndrome. A replacement surgery of mitral valve was proposed. Conclusion: Infectious endocarditis is a disease with multiple and varied modes of revelation. Although skin manifestations are rare, they are still a determining factor in the diagnosis of infectious endocarditis.

Clinical case of multisystem inflammatory syndrome development in a child with new coronavirus infection

Objective:The article deals with a clinical case of new coronavirus infection in a 1 5-year-old child who was receiving treatment in an infectious diseases hospital of City Children's Clinical Hospital №3 during the period from 1 0 October to 1 December 2020.Materials and methods. The diagnosis was confirmed through nasal swabs examination for the presence of SARS-CoV-2 RNA using PCR and SARS-CoV-2 IgM detection through ELISA.Results.The main feature of the infection course in the present patient was multisystem inflammatory syndrome development with long-term fever, maculopapular rash and multisystemic lesions including bilateral pneumonia, acute carditis and polyserositis.

Multisystem inflammatory syndrome in children - a clinical example in pediatrics

Annotation. Peculiarities of clinical course and differential diagnosis of multisystem inflammatory syndrome (MIS-C) in children with coronavirus infection are described. The main features of this disease are long-term fever, multiorgan dysfunction, laboratory signs of inflammation and positive tests for SARS-CoV-2 (polymerase chain reaction using reverse transcription (RT-PCR), antigen test or positive serological test). The criteria of the World Health Organization (WHO) and the US Centers for Disease Control and Prevention (CDC) are used to confirm the MIS-C diagnosis.

Facial nerve palsy may indicate coronary artery lesions in Kawasaki disease.

Facial nerve palsy (FNP) is extremely rare in Kawasaki disease (KD) and the incidence is just 0.9-1.3%. Our objective was to study the clinical features and prognosis of KD accompanied with FNP and to determine whether FNP indicated an increased risk of coronary artery lesions (CALs) in KD. An observational study was performed on 9 patients diagnosed as KD accompanied with FNP in Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China between September 2012 and December 2019. Patients were followed up from September 2012 till September 2020. Clinical features, laboratory and echocardiography findings, treatments, and prognosis were analyzed retrospectively. And the clinical data of patients with FNP (group A, n = 9) were compared to matched KD patients without FNP (group B, n = 27) in order to determine whether FNP indicated an increased risk of CALs in KD. The matching factors included sex, age, days of illness at the intravenous immunoglobulin use, and classic/incomplete KD forms. Clinical data of 9 patients were analyzed in this study. Patients tended to be younger than 24months of age (88.9%) and 55.6% were under 12months. Median onset of FNP was day 10 of illness. Eight patients (88.9%) showed unilateral FNP. The levels of laboratory inflammatory markers (White blood cells count, neutrophil percentage, C-reactive protein, erythrocyte sedimentation rate, etc.) were significantly increased in most cases. CALs were noted in 8 of 9 patients (88.9%). Coronary artery aneurysms occurred in 4 cases (44.4%) and the remaining 4 patients showed coronary artery dilation. All patients were given intravenous immunoglobulin therapy (2g/kg), aspirin (30-50mg/kg/day), and short-term dexamethasone. During follow-up, both FNP and CALs were completely recovered in all patients. The duration time of FNP ranged from 10 to 130days. And the time for CALs to normal ranged from 12 to 282days. The occurrence of CALs was significantly higher in patients with FNP than those without FNP (88.9% vs. 25.9%, P < 0.05). KD accompanied with FNP is rare but may indicate an increased risk of CALs. Clinicians should take KD into consideration when children suffer from long-term fever with FNP, even with incomplete diagnostic features. With a long-term follow-up, both FNP and CALs have a good prognosis. • Facial nerve palsy may indicate an increased risk of coronary artery lesions in Kawasaki disease. • Clinicians should take Kawasaki disease into consideration when children suffer from long-term fever with facial nerve palsy, even with incomplete diagnostic features. • Facial nerve palsy and coronary artery lesions have a good prognosis in a long-term follow-up.

Psychoneuroimmunological aspects of post covid19 syndrome

A sample screening study was conducted by anonymous questionnaire of 223 adult outpatients with signs of post COVID19 syndrome (PCS) from 1 to 3 months after the disease. Among the respondents 77.6% are men, 22.4% are women of different ages. Young and middle-aged people predominated. 77.3% of them were treated on an outpatient basis. 89.6% of respondents had mild to moderate disease. Viral pneumonia was diagnosed in 28.2%. Respiratory distress syndrome survived 5,8%. Re-infection of SARS-CoV-2 had 3,5%. Prolonged low-grade fever (more than 4 weeks) after the disease was maintained at 33.6%; in 15,6% revealed immunosuppression of the cell and phagocytosis. 75% were diagnosed with long-term fever of non-infectious origin. Complete recovery from 2 to 4 weeks was noted by 82.9%. Three months or more required 19,2% for convalescence. They were dominated by signs of CFS and psycho-emotional imbalance. Regarding cognitive disorders, the greatest difficulties arose with the perception of information in 12.7%, with its analysis in 9.8%, with decision-making in 8%. 25.9% of respondents note mnemonic disorders. Attention disorders occurred in 24.9% of respondents. Among the most pronounced mental states that manifested themselves in the post COVID19 period are: anxiety was: high level - 21%, medium level – 26.6%, low level – 40.7% of respondents, as well as irritability: severe – 37.5 %, expressed – 27.2%, weakly expressed – 35.3%; confusion: severe – 36.6%, severe – 19.1%, mild – 44.1%; depressive disorders: severe – 36.5%, severe – 19.1%, mild – 44.1%; fear, despair, apathy: strongly expressed – 33.9%, expressed – 26.3%, weakly expressed – 39.8% of respondents; panic, panic attacks was: high level – 41%, medium level – 14,1%, low level – 44.9%, hysteria: strongly expressed – 42.7%, expressed –13.5%, weakly expressed – 47.6%; aggression, anger, irritability: strongly expressed – 41.9%, expressed – 18.9%, weakly expressed – 39.3% of respondents. A change in the value-semantic component of personality has been recorded. Thus, 38.9% of respondents became more aware of the value of life, 17.2% had a positive attitude towards the world.

Actinotignum schaalii and Aerococcus urinae as Etiology of Infected Kidney Cyst: A Diagnostic Challenge

The case presented here illustrates a sometimes complex disease presentation where interdisciplinary teamwork is essential. A 74-years-old woman with stable chronic obstructive pulmonary lung disease and a composite graft aortic valve implant was admitted to hospital with an episode of acute lower back pain combined with long-term fever. The final diagnoses of a left-sided, infected and radiologically evident kidney cyst caused by the urinary tract pathogens Actinotignum schaalii and Aerococcus urinae was established by the use of partial 16S/18S rRNA gene sequence analysis on kidney cyst drainage material taken after four weeks of relevant antibiotic therapy.

Evaluating the added predictive ability of MMP-9 in serum for Kawasaki disease with coronary artery lesions

To investigate the predictive ability of serum matrix metalloproteinase-9 (MMP-9) in the acute phase of Kawasaki disease (KD) with coronary artery lesions (CALs). Patients with KD hospitalized in Lanzhou University...

Long-term fever in a child: what is the reason, how to examine, treat or not treat?

Long unclear fever in children of different ages remains one of the difficult and topical issues in the paediatric practice. Despite up-to-date techniques of laboratory and instrumental examination, verification of prolonged fever causes remains difficult; it cannot be deciphered in 10% of cases. It is especially important to differentiate fever from hyperthermia in paediatric practice. The article provides an overview of the status update on the issue. The mechanisms of fever and hyperthermia are described, criteria for fever of unknown origin are given. It is stated that infectious diseases under the guise of fever of unknown origin develop in 60–70% of children. Systemic connective tissue disease and vasculitis are detected in 20% of cases, hemato-oncological – in 5%, auto-inflammatory – in 5%, the cause of fever remains unknown in 10% of cases. The article provides clinical observations of children with diseases debuting as fever of unknown origin with the following diagnoses: juvenile rheumatoid arthritis (JRA), a systemic variant with high activity (DAS index 28 = 5.1 at the rate of &lt; 2.6); mucocutaneous lymphonodular syndrome (Kawasaki syndrome), damages of cardiovascular system (small coronary artery aneurysms), bacterial-viral infection; auto-inflammatory syndrome – mevalonate kinase deficiency syndrome (hyper-IgD syndrome). Diagnostic approaches to the verification of febrile condition are outlined. It is noted that treatment should not be started in a stable condition of the patient without establishing the cause of the fever, and it is advisable to use only an antipyretic agent with central and peripheral effects, pronounced antipyretic effect, analgesic and anti-inflammatory effects.

A phase II study of anlotinib with cediranib as a second-line treatment for patients with advanced biliary tract cancers (aBTCs).

e16712 Background: Gemcitabine combined with cisplatin (GP) is currently used as a standard first-line chemotherapy regimen for aBTCs, However, the median overall survival (mOS) is only about 11.7 months, and there is no standard treatment option for patients who failed GP therapy. In this study, we aimed to investigate the efficacy and safety of anlotinib with cediranib as a second-line treatment for patients with aBTCs. Methods: A monocenter single-arm phase II study was conducted at the First Affiliated Hospital of Zhengzhou University. Patients with measurable aBTCs and progressed on GP were enrolled in this study. Patients received cediranib 200mg, on day1 + anlotinib 12mg on day1-14, Q3W until disease progression, intolerance of toxicity, investigator/patient decision to withdraw or other reasons specified in the protocol. Response (RECIST1.1) was assessed every 8 weeks. Plasma, stool and tumor tissues were collected for exploratory analyses. The primary endpoint was overall survival (OS). Secondary endpoints included progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR) and drug safety. Results: We planned to include 20 patients. So far 9 patients were enrolled in this study, 66.7% (6/9) were men, 33.3% were women. The median age was 56y (43y-61y). The primary sites of the tumor were intrahepatic biliary (66.7%, 6/9) and gallbladder (33.3%, 3/9). At data cutoff (Dec 14, 2019), the median duration of follow-up was 2.5mos (range, 1.2 to 4) and all of the patients were still under treatment. 8 patients have undergone at least one efficacy evaluation, of which 2 (25%) PR, 5 SD (62.5%), DCR was 87.5% ((7/8). An SD patient had a long-term intermittent fever, which considered to be tumor fever, the body temperature returned to normal after 1 cycle of treatment. 1 patient was considered to be undefined because, at the first evaluation, the liver lesions were reduced however the lymph nodes in the retroperitoneum were enlarged. The median PFS and OS not yet reached. Grade 3-4 treatment-related adverse events (TRAEs) occurred in 11.1% (1/9) of patients. TRAEs led to discontinuation in 1 patient (grade 3 hypertension). TRAEs led to dose reduction of anlotinib in 2 patients. No TRAEs were fatal. Conclusions: The primary result showed that the combination of anlotinib and cediranib was well tolerated and demonstrates encouraging efficacy than historical control in second-line treatment for aBTC. Updated data, including safety, efficacy, and biomarkers will be presented. Clinical trial information: ChiCTR1900022003 .

Giant LV Thrombose and Thrombosed Coronary Aneurysm in an Infant with Kawasaki Disease

Background Kawasaki disease (KD) also known as mucocutaneous lymph node syndrome is the febrile and self-limited vasculitis that occurs in children of all ages, especially younger than five years of age. Here, we describe a case of Kawasaki disease with coronary artery aneurysm and a big clot in LV with a diameter of 1.5 cm. Case Presentation In February 2019, a 10-month-old boy with a complaint of weakness and lethargy was referred to Imam Reza hospital in Mashhad (Iran). The patient has had coughs with no response to drug treatment for the past four months. Gallop rhythm was present in heart auscultation. Hepatomegaly was observed in physical examination. No lymphadenopathy was seen, but scalded skin was observed. On the second day of hospitalization in our center, he developed non-purulent bilateral conjunctivitis, strawberry tongue, and maculopapular rashes on the body and distal parts of the limbs. Echocardiography showed dilation of the heart chamber, blood clot in the left ventricle (LV) with the size of 1.5 cm, moderate to severe tricuspid regurgitation (TR), giant aneurysm (0.8 cm) in the left anterior descending coronary artery (LAD), right coronary artery (RCA) aneurysm (0.6 cm), and decreased ejection fraction (EF). Conclusion Kawasaki disease must be considered in the differential diagnosis of patients presenting symptoms of infection including fever and weakness, especially in infants. Early diagnosis of Kawasaki disease can lower the chance of complication including coronary artery aneurysms. Therefore, this disease must be permanently considered in patients (especially in infants) with long-term fever without a typical presentation of Kawasaki to avoid severe heart complications.

Rosai Dorfman Destombes’s Disease about 5 Cases

Rosai Dorfman’s Disease (RDD) Destombes also called sinus histiocytosis with massive lymphadenopathy is a lymphoproliferative pathology usually benign, of unknown etiology, and of low incidence. It is a rare, but well-defined clinicopathological entity, which predominantly affects children and adolescents without distinction of gender or race. It manifests itself generally by bulky cervical lymphadenopathies, most often bilateral, painless, of benign but persistent evolution and a long-term fever associated with a non-specific biological inflammatory syndrome. Extra lymph node locations are described in association with lymph node involvement or isolation. The definitive diagnosis of Rosai Dorfman’s disease is histological, characterized by histiocytic infiltration with emperipolesis essentially of lymphocytes. The etiopathogenesis of the condition remains unclear, based on infectious and immunological hypotheses without clear evidence. The management is not well codified, it combines depending on the case, surgery; corticosteroids; antimetabolites and interferon alpha. Studies devoted to this condition in tropical Africa are rare. We report the clinical and progressive features of 5 observations of Rosai Dorfman’s disease.

CLINICAL CASE OF INCOMPLETE KAWASAKI DISEASE

Kawasaki disease (KD) is one of the most common vasculitis occurring in children under 5 years, difficult to diagnose due to the presence of a wide range of nonspecific manifestations. It is especially difficult to diagnose an incomplete KD, as it has less pronounced symptoms, is more common in children under 4 year and poses a threat of developing dangerous cardiovascular complications. Unexplained long-term fever in infants may be the only manifestation of the acute stage of the disease, while the cardiovascular system is often involved in the pathological process later (in the second week of the disease) and often remains undiagnosed. This article presents the result of own clinical observation of a child of 3 months with incomplete KD. The importance of timely echocardiography of coronary vessels in children with the debut of long-term fever of unclear etiology is emphasized. It should be remembered that a timely diagnosis allows you to prescribe adequate therapy and prevent the development of serious complications.