Atypical Kawasaki disease presenting with macroscopic hematuria in an infant: a case report

Abstract Background Kawasaki disease is an acute febrile condition in children. It affects mainly children under 5 years old, and is known to cause coronary artery abnormalities if treatment is delayed. The diagnosis rests mainly on clinical criteria. However, it is also known that some infants do n...

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Main Authors: V. Thadchanamoorthy, Kavinda Dayasiri, I. R. Ragunathan
Format: Article
Language:English
Published: BMC 2023-01-01
Series:Journal of Medical Case Reports
Subjects:
Online Access:https://doi.org/10.1186/s13256-022-03739-3
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author V. Thadchanamoorthy
Kavinda Dayasiri
I. R. Ragunathan
author_facet V. Thadchanamoorthy
Kavinda Dayasiri
I. R. Ragunathan
author_sort V. Thadchanamoorthy
collection DOAJ
description Abstract Background Kawasaki disease is an acute febrile condition in children. It affects mainly children under 5 years old, and is known to cause coronary artery abnormalities if treatment is delayed. The diagnosis rests mainly on clinical criteria. However, it is also known that some infants do not have diagnostic criteria sufficient enough for the diagnosis of Kawasaki disease. Further, children may rarely present with unusual features, and this entity is recognized as “Atypical Kawasaki disease.” Case presentation We present the case of a 9-month-old Tamil boy who presented with sterile gross hematuria in association with prolonged fever, lymphadenopathy, and generalized maculopapular rash. He had high inflammatory markers and echocardiogram disclosed left coronary artery dilatation. The diagnosis of incomplete Kawasaki disease was confirmed based on clinical grounds supported by investigations and exclusion of differential diagnosis. The child showed a good response to intravenous immunoglobulin and aspirin. Conclusion Kawasaki disease is one of the important differential diagnoses of protracted fever of unknown origin in very young children. Since delayed treatment is associated with a high risk of complications, atypical Kawasaki disease needs to be suspected in children presenting with unusual features such as macroscopic hematuria that occurs in association with unexplained prolonged fever.
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spelling doaj.art-e7033d3d78744aa4b964bd72f9431a7b2023-01-15T12:13:05ZengBMCJournal of Medical Case Reports1752-19472023-01-011711410.1186/s13256-022-03739-3Atypical Kawasaki disease presenting with macroscopic hematuria in an infant: a case reportV. Thadchanamoorthy0Kavinda Dayasiri1I. R. Ragunathan2Faculty of Health Care Sciences, Eastern UniversityFaculty of Medicine, University of KelaniyaTeaching HospitalAbstract Background Kawasaki disease is an acute febrile condition in children. It affects mainly children under 5 years old, and is known to cause coronary artery abnormalities if treatment is delayed. The diagnosis rests mainly on clinical criteria. However, it is also known that some infants do not have diagnostic criteria sufficient enough for the diagnosis of Kawasaki disease. Further, children may rarely present with unusual features, and this entity is recognized as “Atypical Kawasaki disease.” Case presentation We present the case of a 9-month-old Tamil boy who presented with sterile gross hematuria in association with prolonged fever, lymphadenopathy, and generalized maculopapular rash. He had high inflammatory markers and echocardiogram disclosed left coronary artery dilatation. The diagnosis of incomplete Kawasaki disease was confirmed based on clinical grounds supported by investigations and exclusion of differential diagnosis. The child showed a good response to intravenous immunoglobulin and aspirin. Conclusion Kawasaki disease is one of the important differential diagnoses of protracted fever of unknown origin in very young children. Since delayed treatment is associated with a high risk of complications, atypical Kawasaki disease needs to be suspected in children presenting with unusual features such as macroscopic hematuria that occurs in association with unexplained prolonged fever.https://doi.org/10.1186/s13256-022-03739-3Atypical KDMaculopapular rashProlonged fever
spellingShingle V. Thadchanamoorthy
Kavinda Dayasiri
I. R. Ragunathan
Atypical Kawasaki disease presenting with macroscopic hematuria in an infant: a case report
Journal of Medical Case Reports
Atypical KD
Maculopapular rash
Prolonged fever
title Atypical Kawasaki disease presenting with macroscopic hematuria in an infant: a case report
title_full Atypical Kawasaki disease presenting with macroscopic hematuria in an infant: a case report
title_fullStr Atypical Kawasaki disease presenting with macroscopic hematuria in an infant: a case report
title_full_unstemmed Atypical Kawasaki disease presenting with macroscopic hematuria in an infant: a case report
title_short Atypical Kawasaki disease presenting with macroscopic hematuria in an infant: a case report
title_sort atypical kawasaki disease presenting with macroscopic hematuria in an infant a case report
topic Atypical KD
Maculopapular rash
Prolonged fever
url https://doi.org/10.1186/s13256-022-03739-3
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AT irragunathan atypicalkawasakidiseasepresentingwithmacroscopichematuriainaninfantacasereport