Pneumonia, an uncommon presentation of Kawasaki disease- two case reports.
2Pediatric Pulmonology Unit and CF Center, Carmel Medical Center
3B. Rappaport Faculty of Medicine, Technion–Israel Institute of Technology
4Pediatric Rheumatology Unit, Carmel Medical Center
Background: Kawasaki disease (KD) is a multi-systemic vasculitis of childhood. It affects medium-sized arteries, predominantly the coronary arteries, but also has pulmonary manifestations which are not commonly recognized. The etiology of KD remains unclear, though various hypotheses on the role of an infectious trigger for KD have been postulated.
Case presentation: Two cases of KD manifested as persistent lung consolidation associated with Group A Streptococcus (GAS) and Influenza A co-infection, prolonged fever, and active inflammatory laboratory markers unresponsive to antibiotic treatment are reported. One of the children developed pleural effusion that necessitated chest tube drainage. In both cases resolution of fever and pulmonary manifestations were achieved following administration of Intravenous Immunoglobulin (IVIG) treatment.
Conclusion: Pediatricians should consider the diagnosis of KD in the presence of pneumonia that is nonresponsive to antibiotic therapy with prolong fever and inflammatory reaction. This can prevent delay in diagnosis and the detrimental sequelae. Also, the potential mechanism underlying pathogen infection-mediated KD requires further investigation, which may provide scientific evidence for the pathogenesis of KD.