Overcoming diagnostic challenges in an incomplete Kawasaki disease: A case report in an infant

Kawasaki disease (KD) is an acute febrile illness of unknown aetiology that affects primarily children <5 years of age. It is a systemic inflammatory disorder manifesting as a vasculitis that predominantly affects the mediumsized arteries with a predilection for the coronary arteries. We report a case of incomplete KD in a 3-month-old child. The infant had an atypical presentation, overlapping with evidence of urinary tract infection and aseptic meningitis. Typical signs such as bacillus calmette guerin site induration, rash, erythematous lips and strawberry tongue developed later in the course of the disease. At the time of diagnosis of KD, the infant already had coronary artery dilatation with a Z score of 2.3. The child responded well to one dose of intravenous immunoglobulin and aspirin. Following discharge, the child was followed up over the next 1 year. The child is doing well and is continuing on an antiplatelet dose of aspirin.