Afebrile Kawasaki disease with coronary artery dilatation.
Herein we describe the cases of two afebrile patients who were thought to have Kawasaki disease (KD). Patient 1 was a 7-month-old-Japanese girl. She presented with bulbar conjunctival injection, diarrhea, skin erythema, and redness around the bacillus Calmette-Guerin (BCG) inoculation site. Thirteen days after the first symptoms, ultrasonic cardiogram (UCG) showed dilatations of the bilateral coronary arteries (CA). The dilatations had completely resolved 5 months later. Patient 2 was a 13-month-old Japanese boy. He first presented with bulbar conjunctival injection and redness around the BCG inoculation site. Twenty-two days after the first symptoms, UCG indicated bilateral and peripheral CA dilatations. The mild dilatations of the proximal CA remained. Although fever is the principal symptom of KD, some incomplete KD patients may be afebrile. Although it is difficult to diagnose these patients as having KD, redness at the BCG inoculation site may be a clue to the diagnosis.
Department of Microbiology and Immunology, Saitama Children's Medical Center, Saitama City, Saitama, Japan.|Department of Pediatrics, Koshigaya Hospital, Dokkyo Medical University, Koshigaya, Saitama, Japan.|Department of Nephrology, Koshigaya Hospital, Dokkyo Medical University, Koshigaya, Saitama, Japan.
Atsunori
A
Yoshino
Department of Microbiology and Immunology, Saitama Children's Medical Center, Saitama City, Saitama, Japan.
Risa
R
Tanaka
Department of Microbiology and Immunology, Saitama Children's Medical Center, Saitama City, Saitama, Japan.
Tadamasa
T
Takano
Department of Microbiology and Immunology, Saitama Children's Medical Center, Saitama City, Saitama, Japan.
Tsutomu
T
Oishi
D003324:Coronary Artery Disease / Q000209:etiology* / Q000473:pathology; D003331:Coronary Vessels / Q000473:pathology; D004108:Dilatation, Pathologic / Q000209:etiology; D005260:Female; D005334:Fever; D006801:Humans; D007223:Infant; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications / Q000175:diagnosis* / Q000473:pathology
Kawasaki disease; afebrile; bacillus Calmette-Guerin; coronary artery dilation; heat shock protein