Kawasaki Disease with Peripheral and Facial Gangrene: A Case report and review of literature

Trop Doct. 2022 Jul;52(3):449-452. doi: 10.1177/00494755221081598. Epub 2022 Mar 29.

Abstract

With the onset of the SARS-CoV-2 pandemic, Kawasaki Disease (KD) has come to the fore with its many atypical manifestations. Atypical clinical neurological, ophthalmological, musculoskeletal, gastrointestinal and pulmonary manifestations in a febrile child with raised markers should prompt the clinician to think of Kawasaki disease. Peripheral gangrene is a rare atypical manifestation of KD reported in infancy. We present a three-and-a-half-year-old boy with extensive gangrene all four limbs and face along with purpura fulminans. He was successfully treated with two doses of intravenous immunoglobulin (IVIG) and infliximab, with no residual gangrene. This case highlights that very severe forms of Kawasaki disease require IVIG, pulse steroids as well as infliximab for adequate control and complete resolution of the disease.

Keywords: Gangrene; IVIG; Kawasaki disease; infliximab; purpura fulminans.

Publication types

  • Case Reports
  • Review

MeSH terms

  • COVID-19* / complications
  • Child, Preschool
  • Gangrene / diagnosis
  • Gangrene / etiology
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Infliximab / therapeutic use
  • Male
  • Mucocutaneous Lymph Node Syndrome* / complications
  • Mucocutaneous Lymph Node Syndrome* / diagnosis
  • Mucocutaneous Lymph Node Syndrome* / drug therapy
  • SARS-CoV-2

Substances

  • Immunoglobulins, Intravenous
  • Infliximab