Kawasaki Shock Syndrome in a 12-Year-Old Girl Mimicking Septic Shock

Abstract

Kawasaki disease is diagnosed when fever lasts for more than 5 days with the presence of four out of five of the following clinical features: bilateral conjunctival congestion, changes in the lips and oral cavity, polymorphous exanthem, changes in peripheral extremities, and acute nonpurulent cervical lymphadenopathy (Nakamura et al., 2012). The average age of onset is 2 years and 90% of patients are below 5 years of age. Boys are more affected than girls (Cox and Sallis, 2009). This case report describes an adolescent female who was initially managed as having septic shock and subsequently found to have Kawasaki shock syndrome.

Clinical characteristics of Kawasaki disease in adolescents

“…Another 18 cases were documented in other case reports. [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] Among the 136 reported cases, including ours, the oldest patient was 17 years old, 27,32 suggesting that KD can affect patients of any age because adult-onset KD in patients from 18 to 68 years of age has also been previously identified. KD in adolescents is more likely to affect male patients.…”

Kawasaki Disease Shock Syndrome Presenting as Septic Shock in a Child With Incomplete Kawasaki Disease

“…Kawasaki disease shock syndrome, along with septic shock and toxic shock, should be included in the differential diagnosis of children who present with fever and hypotension, predominantly in children who show poor clinical response to antibiotic treatment and whose blood and urine cultures remain negative. Early echocardiography may be a useful tool when KDSS is suspected 5 …”