Atypical Kawasaki Disease Presentation in a Previously Healthy Infant: A Diagnostic Challenge

Kawasaki disease (KD) is an acute systemic vasculitis primarily affecting children, characterized by fever and multisystem involvement. We present a compelling case of KD in a previously healthy 13-week-old infant who presented with fever, irritability, reduced feeding, and the subsequent development of classical mucocutaneous manifestations, including bilateral non-purulent conjunctivitis, cracked lips, and an erythematous rash. Laboratory findings revealed elevated inflammatory markers, thrombocytosis, and neutrophilic leukocytosis, consistent with the diagnosis. The patient was started on intravenous immunoglobulins (IVIG) at a dose of 2g/kg, IV methylprednisolone, and a high dose of aspirin. The infant was eventually transferred to a tertiary care hospital for comprehensive management. The case is intriguing due to its presentation in an atypical age group. Prompt recognition and management of KD are crucial to prevent the development of coronary artery abnormalities. This case underscores the importance of considering KD in the differential diagnosis of infants with fever and unusual clinical presentations, even in the absence of typical cardiac involvement. Early identification and appropriate treatment are essential to prevent potential complications and improve outcomes.