Giant coronary artery aneurysms in a 12-week-old infant with incomplete Kawasaki disease

BMJ Case Rep. 2018 Mar 28:2018:bcr2018224479. doi: 10.1136/bcr-2018-224479.


Kawasaki disease (KD) is an acute inflammatory vasculitis that occurs worldwide and disproportionately affects male children, most commonly between the ages of 6 months and 5 years. KD can present with only a few features and thus be difficult to diagnose, particularly in the youngest and oldest patients. We describe a 12-week-old Caucasian female infant who presented with rash and fever but no other features of KD, who developed giant coronary artery aneurysms. Considering how common is the presentation of a febrile infant with a rash, this case highlights the importance of considering KD early in the differential diagnosis for any infant with unexplained fever. Furthermore, it emphasises how echocardiography can help in the investigation of a febrile child with no clear source of infection.

Keywords: cardiovascular medicine; paediatrics; vasculitis.

Publication types

  • Case Reports

MeSH terms

  • Anti-Inflammatory Agents / therapeutic use
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Aspirin / therapeutic use
  • Coronary Aneurysm / complications*
  • Coronary Aneurysm / diagnostic imaging
  • Coronary Aneurysm / therapy
  • Coronary Vessels / diagnostic imaging
  • Diagnosis, Differential
  • Echocardiography / methods
  • Female
  • Humans
  • Immunoglobulins / therapeutic use
  • Infant
  • Methylprednisolone / therapeutic use
  • Mucocutaneous Lymph Node Syndrome / complications*
  • Mucocutaneous Lymph Node Syndrome / diagnosis
  • Mucocutaneous Lymph Node Syndrome / therapy


  • Anti-Inflammatory Agents
  • Anti-Inflammatory Agents, Non-Steroidal
  • Immunoglobulins
  • Aspirin
  • Methylprednisolone