The term "incomplete Kawasaki disease (IKD)" was first used to describe patients with coronary complications who did not meet the classic diagnostic criteria for Kawasaki disease (KD). The risk of coronary artery involvement is similar, if not greater, in cases of IKD. However, recognition of IKD is challenging and often delayed, especially in infants. Several algorithms have been formulated to identify cases of IKD using supplemental clinical, echocardiographic, and laboratory features. Although fever is not required for the diagnosis of KD in the Japanese guideline, most current guidelines, including those from the American Heart Association (AHA), consider the presence of fever for at least seven days as a requirement for the diagnosis of both KD. and IKD in infants. A review of the literature identified similar cases with a growing consensus on the need to redefine the role of fever. The pediatrician must look for lesions in the coronary arteries in cases of high clinical suspicion, even if the febrile period is short, especially in children younger than six months. In addition, more groundbreaking research is directly needed to identify immunological and cellular markers that can be tested early in the disease course and guide management.

Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis. Central nervous system involvement occurs in approximately 1-8% of all patients with active tuberculosis. This is a case report diagnosed by the Pediatrics Service of the Hospital Escola de Valença (HEV), in the city of Valença -RJ from April 2021 to May 2021. The clinical manifestations are varied: in most patients there are persistent evening fever for more than 15 days, radiological image without improvement with the use of antimicrobials for common germs, history of a family member with chronic cough or contact with patients with tuberculosis. This report highlights the importance of recognizing the pattern of complications in TB despite the absence of microbiological confirmation. It also demonstrates the challenge in arriving at diagnosis, given that there is absolute specificity in the gold standard diagnostic tool (TB culture), despite repeated large-volume CSF analysis, and the low sensitivity of CSF TB PCR. The case is special in illustrating the sum of these complications that occur concomitantly.