Recurrent course of Kawasaki disease with cardiac and joint complications – a case report

Kawasaki disease is an acute systemic vasculitis of unknown aetiology. The diagnosis and treatment of the typical course of the disease have already been well described. However, in atypical, recurrent, or complicated Kawasaki disease cases, diagnostic and therapeutic decisions may be challenging. We present the case of a 3.5-year-old boy who presented with typical Kawasaki disease symptoms. Complete Kawasaki disease was diagnosed, and the boy was initially assigned as a low-risk patient, but he developed persisting fever and finally giant coronary aneurysms despite treatment according to the recommendations. Shortly after discharge, the boy was re-admitted due to limping. Two similar relapses were observed over the period of three months and the boy was ultimately diagnosed with recurrent Kawasaki disease complicated by arthritis. The initial typical presentation of Kawasaki disease may not predict its further course, recurrence, or potential complications.