A 12-year-old boy with Kawasaki Disease that was Difficult to Diagnose

Kawasaki disease was first reported by Tomisaku Kawasaki in 1967 and there have been 200,000 cases reported in Japan. It is predominantly a disease of young children, and 80% of the patients are younger than 5 years of age. We report a case of Kawasaki disease that was difficult to diagnose. A 12-year-old boy was referred to our hospital with a fever of 40 degrees Celsius and swelling of the right neck lymph nodes, despite a course of antibiotics. A CT scan of the neck showed multiple swollen lymph nodes and laryngeal-edema. He was hospitalized on the same day. After 10 days of fever, point-like eruptions appeared on his chest and he developed conjuctival congestion. Therefore, he was diagnosed as having Kawasaki disease and was treated with γ-globulin (2 g/kg) and aspirin (40 mg/kg/day). On the day after beginning this treatment, his body temperature fell to 37 degrees Celsius, and the pointed eruptions and conjuctival congestion improved gradually. He was discharged from the hospital after 23 days after on set of fever.