title: Adult Kawasaki disease in a European patient: a case report and review of the literature.
abstract: BACKGROUND
  Kawasaki disease is an acute necrotising vasculitis of the medium- and small-sized vessels, occurring mainly in Japanese and Korean babies and children, aged 6 months to 5 years. Its main complication is damage of coronary arteries, which has the potential to be fatal. Here we report a rare case of Kawasaki disease that occurred in a 20-year-old Greek adult.
  
  
  METHODS
  A 20-year-old Greek man presented with high fever, appetite loss, nausea and vomiting, headache and significant malaise. He had an erythema of the palms and strikingly red lips and conjunctiva. As he did not respond to broad-spectrum antibiotics and after having excluded other possible diagnoses, the diagnosis of Kawasaki disease was set. He was treated with intravenous immunoglobulin and oral aspirin on the 10th day since the onset of the illness. His clinico-laboratory response was excellent and no coronary artery aneurysms were detected in coronary artery computed tomography performed 1 month later.
  
  
  CONCLUSIONS
  This report of an adult case of European Kawasaki disease may be of benefit to physicians of various specialties, including primary care doctors, hospital internists, intensivists and cardiologists. It demonstrates that a case of prolonged fever, unresponsive to antibiotics, in the absence of other diagnoses may be an incident of Kawasaki disease. It is worth stressing that such a diagnosis should be considered, even if the patient is adult and not of Asian lineage.
authors.affiliation: 3rd Department of Internal Medicine, Evangelismos Hospital, Ipsilantou 45-47, 10676, Athens, Greece. tkontopoulou@yahoo.gr.
authors.forename: Theano
authors.initials: T
authors.lastname: Kontopoulou
authors.affiliation: Department of Life Sciences, Imperial College London, Silwood Park Campus, Buckhurst Road, Ascot, SL5 7PY, UK. d.kontopoulos13@imperial.ac.uk.
authors.forename: Dimitrios Georgios
authors.initials: DG
authors.lastname: Kontopoulos
authors.affiliation: Department of Internal Medicine, Metropolitan Hospital, Ethnarchou Makariou 9 & El. Venizelou 1, 18547, N. Faliro, Athens, Greece. vaidakismanolis@gmail.com.
authors.forename: Emmanouel
authors.initials: E
authors.lastname: Vaidakis
authors.affiliation: 3rd Department of Internal Medicine, Evangelismos Hospital, Ipsilantou 45-47, 10676, Athens, Greece. geomousoulis@yahoo.gr.
authors.forename: George P
authors.initials: GP
authors.lastname: Mousoulis
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D003323:Coronary Aneurysm; D004890:Erythema / Q000209:etiology; D005334:Fever / Q000209:etiology; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007155:Immunologic Factors / Q000627:therapeutic use; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000175:diagnosis* / Q000188:drug therapy / Q000208:ethnology; D044465:White People; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D001241:Aspirin