Journal of Pediatric Cardiology and Cardiac Surgery

Incomplete Kawasaki disease (iKD) is widely accepted as a risk factor for developing coronary artery lesions, partly because of a delay in treatment initiation. However, its association with giant aneurysm (GA) formation has rarely been reported. Here we report a 3-year-old boy with iKD who developed multiple GAs at both the right and left coronary arteries. The boy was admitted to a previous hospital for fever lasting for seven days and conjunctival injection. First, he was treated with antibiotics, but his fever did not resolve. Echocardiography revealed remarkable dilatation of the bilateral coronary arteries. He was transferred to our hospital under the diagnosis of iKD on day 11 of illness. His symptoms improved immediately after the administration of intravenous immunoglobulin, but the diameter of his coronary aneurysms increased. Coronary angiography performed three months after onset revealed multiple GAs at both coronary arteries. An aneurysm at the right coronary artery occluded two years from onset. In case of prolonged fever of unknown origin, it is important to consider incomplete KD and carefully examine echocardiograms, even when there are few major KD symptoms present.