Atypical Kawasaki Disease in a 16-Month-Old Baby: A Case Report and Literature Review

Kawasaki illness is an inflammatory condition of small- to medium-sized vessels that primarily affects children. It affects the lymph nodes, skin, mucous membranes, and heart, especially the coronary arteries. Patients who lack the comprehensive clinical manifestations of classic Kawasaki disease (KD) are typically evaluated for incomplete KD. Such patients have persistent fever and lack one or more characteristic clinical signs. Here, we present a case of a 16-month-old baby presented with fever for nine days, excessive crying and irritability for four days, and refusal to feed for one day with pallor and developed lip cracking, mucositis, bilateral edema, and redness in the palms and soles followed by periungual desquamation. Lab evaluations revealed anemia, elevated white cell count, and c-reactive protein along sterile pyuria. Since the child became afebrile after ten days of illness, inflammatory marker levels decreased, and no coronary artery abnormalities were detected on 2D echocardiography, and the child was diagnosed with incomplete KD based on the clinical, laboratory, and radiological evaluations after ruling out all other possible causes. He was managed conservatively with low-dose aspirin, and the child was doing well on a two-month follow-up.