Journal of Pediatric Cardiology and Cardiac Surgery

Online ISSN: 2433-1783 Print ISSN: 2433-2720
Japanese Society of Pediatric Cardiology and Cardiac Surgery
Japanese Society of Pediatric Cardiology and Cardiac Surgery Academy Center, 358-5 Yamabuki-cho, Shinju-ku, Tokyo 162-0801, Japan
Journal of Pediatric Cardiology and Cardiac Surgery 6(1): 11-14 (2022)

Case ReportCase Report

Recurrent Kawasaki Disease Complicated by Giant Coronary Aneurysms Showing Only Two Clinical Manifestations

1Department of Pediatrics, Osaka University Graduate School of Medicine ◇ Osaka, Japan

2Department of Pediatrics, Toyonaka Municipal Hospital ◇ Osaka, Japan

3Department of Pediatrics, Fukuyama City Hospital ◇ Hiroshima, Japan

受付日:2021年3月12日Received: March 12, 2021
受理日:2021年6月18日Accepted: June 18, 2021
発行日:2022年1月31日Published: January 31, 2022

We herein report a recurrent case of Kawasaki disease (KD) complicated by giant coronary aneurysms that developed only fever and slight conjunctival injection. A 3-year-old boy developed a cough and fever for one day and was referred to us because of a strong inflammatory reaction. He had a history of complete KD previously, and was treated with intravenous immunoglobulin therapy (IVIG) 7 months ago with no coronary arterial lesion afterward. However, this time, he had a cough and chest X-ray showed consolidation; therefore, we suspected bacterial pneumoniae and started antibiotic therapy. Since this failed to reduce his fever, we administered another antibiotic drug, which was also ineffective. Echocardiography was performed on day 7 from onset and revealed bilateral coronary arterial aneurysms, the appearance of which resembled a string of beads. Based on this finding, he was diagnosed with incomplete KD and IVIG, cyclosporine A, and aspirin were administered. Fever improved 12 hours later, but recurred at 36 hours. Due to the possibility of the further expansion of coronary arterial aneurysms, he was transferred to another hospital for plasma exchange.

Patients with recurrent KD are known to be at risk of coronary arterial lesions. However, since the present case only exhibited 2 main manifestations, making an accurate diagnosis was not straightforward. Therefore, the recurrence of KD needs to be considered in children with fever and a history of KD.

Key words: Kawasaki disease; recurrence; coronary aneurysm; incomplete Kawasaki disease

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