Although
Kawasaki disease (KD) is the most common self-limited
systemic vasculitis in pediatrics, the exact etiology of the disease, its association with other diseases, and pathogens is still unknown. In order to achieve a better understanding and management of the disease, documentation and reporting of atypical cases is justified, particularly with the growing number of children with inflammatory syndrome with clinical features simulating KD during the
COVID-19 pandemic. Here, we present a case of an atypical case of KD presenting as multisystem inflammatory syndrome (MIS) during the
COVID-19 pandemic. Case Presentation. The patient is a 7-year-old girl who developed
fever (39°C) and erythematous multiform
rash on the abdomen and along with
erythema and
edema on the extremities. Laboratory evaluation revealed neutrophilia and
lymphopenia along with elevated
C-reactive protein, erythrocyte sedimentation rate,
troponin,
lactate dehydrogenase,
ferritin, and
D-dimer. Although the patient did not fulfill the KD criteria, based on approved guidelines and approaches regarding atypical KD and
multisystem inflammatory syndrome in children (MIS-C) during the
COVID-19 pandemic,
intravenous immunoglobulin along with
aspirin was administered for the patients. The patient's symptoms resolved with an uneventful postdischarge course.
CONCLUSION: Early diagnosis and treatment of patients meeting full or partial criteria for KD are critical to preventing end-organ damage and other long-term complications, especially during times of public crisis and global health emergencies, such as the novel coronavirus pandemic.