In adolescence, Kawasaki disease (KD) may present with varied clinical pictures, and the classic clinical criteria are often insufficient to establish the diagnosis. This report presents a clinical case of KD in an adolescent and a brief review of the relevant literature, based on a PubMed search using the terms "adolescence" and "KD". A 13-year-old girl presented with fever, rash, hepatomegaly, and ultrasonographic evidence of abdominal lymphadenopathy. On week 2 after onset of symptoms, the patient developed desquamation of the extremities and thrombocytosis. Echocardiography was normal during the acute illness and remained unchanged at 2-year follow-up. Clinicians should be aware that, in adolescents, KD poses a diagnostic challenge and rarely corresponds to the classic presentation. On retrospective analysis, we believe that abdominal lymphadenopathy should have been recognized as a substitute manifestation of the classic symptom of cervical lymphadenopathy to establish the diagnosis of this fearsome systemic vasculitis syndrome.

Acute viral bronchiolitis (AVB) is a frequent respiratory disease in infants, responsible for high morbidity and high hospitalization rates. It has an epidemic pattern prevalent in winter and spring. The most common pathogen is the respiratory syncytial virus. The decision for intensive care unit admission depends on indicators of disease severity, which include: severe dehydration, tachypnea with exertion, wheezing, cyanosis or hypoxemia, altered neurological status. In some cases, bronchiolitis may complicate respiratory failure and require ventilatory support. Another important consideration at the time of admission decision is the presence of comorbidities such as heart disease, extreme prematurity, immunodeficiency, and neuropathy that often lead to unfavorable outcomes. In addition to paying attention to young infants younger than 3 months, who have a worse prognosis and higher mortality rate. In such cases, close medical attention should be sought, with supportive measures necessary for a better outcome of the case. In an intensive care unit in Brazil, after the establishment of a therapeutic protocol for bronchiolitis, favorable results were observed with the use of hypertonic saline, infrequent use of corticosteroids and antibiotics, even in infants who required ventilatory support.