Ali Akbar Razlansari - Assistan t professor, Lorestan University of Medical Sciences, Khorramabad, Iran
Hamid Reza Sherkatolabbasieh - Assistan t professor, Lorestan University of Medical Sciences, Khorramabad, Iran

Background:Kawasaki disease is a multisystem acute febrile vasculitic syndrome of presumably infectious origin which usually occurs in children under 5 years of age and is very rare in infants under 3 months of age and usually associated with a high incidence of incomplete or atypical forms in this age group. Infants age less than 6 months are the most likely to develop prolonged fever (≥ 7 days) without other clinical criteria for Kawasaki disease. These infants are at particularly high risk of developing coronary artery abnormalities.Case presentation:The patient was a previously healthy 2-months old male infant who presented with high grade fever , irritability and respiratory signs from 3 days before admission and was treated with broad spectrum antibiotics. Chest radiography showed infiltration in right lung. After 5 days of antibiotic treatment, respiratory problems improved but the patient still had high grade fever and full sepsis workup including blood cultures was negative. In the course of hospitalization he developed leukocytosis, anemia inappropriate for age, severe thrombocytosis, hypoalbuminemia and high ESR (more than 90) and CRP.Echocardiography was done that showed aneurysmal dilatation of coronary artery ( LAD). So with the impression of Kawasaki disease the patient was treated with high dose aspirin and intravenous immunoglobulin. Over the next 24 hours his symptoms resolved and became totally afebrile and well. Subsequent laboratory tests in the following days showed resolution of leukocytosis, anemia and thrombocytosis and there was no progression in the diameter of coronary aneurysm.Conclusion:This case report signifies the importance of diagnosing Kawasaki disease in infants presenting with prolonged fever and no other explanation for it . Regarding the high risk of developing coronary artery abnormalities in young infants with Kawasaki disease, recognizing this disease in this age group enables appropriate treatment that can result in resolution of symptoms and may decrease the risk of cardiac complications.

Kawasaki, Infant, Coronary artery aneurysm, Intravenous immunoglobulin