title: Periorbital vasculitis complicating Kawasaki syndrome in an infant.
abstract: Periorbital vasculitis is a previously unreported complication of Kawasaki syndrome (KS). We describe an infant with severe KS refractory to initial management with salicylate and intravenous immunoglobulin (IVIG). Retreatment with IVIG and high-dose pulsed steroids was required for persistent fever and inflammatory manifestations. Despite aggressive medical therapy, a large left coronary artery aneurysm developed. After apparent complete KS remission, acute periorbital vasculitis developed in the left upper eyelid and orbit, requiring operative intervention for diagnosis and high-dose pulsed steroids for therapy. The significance of this previously unreported ophthalmic complication of KS is reviewed, along with a discussion of the role of steroids in KS manifestations refractory to IVIG.
authors.affiliation: Department of Family Medicine, Medical College of Georgia, Augusta, GA 30912, USA.
authors.forename: M W
authors.initials: MW
authors.lastname: Felz
authors.forename: A
authors.initials: A
authors.lastname: Patni
authors.forename: S E
authors.initials: SE
authors.lastname: Brooks
authors.forename: R A
authors.initials: RA
authors.lastname: Tesser
mesh_terms: D005141:Eyelid Diseases / Q000209:etiology*; D006801:Humans; D007223:Infant; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications*; D014657:Vasculitis / Q000209:etiology*