[Adult Kawasaki disease]

Abstract

Background: Kawasaki disease is an acute vasculitis seen rarely in adults. Diagnosis is based on fever lasting at least 5 days and four or five major clinical criteria in the absence of any other potential pathological causes.

Case report: A 50-year-old woman taking no new medications immediately beforehand was seen with a febrile maculopapular exanthema present for 3 days, as well as gradual onset of enanthema, cheilitis, odynophagia, adenopathy, peripheral oedema and bilateral conjunctivitis. Fever and markers of inflammation persisted despite 3 days of antibiotic therapy. The diagnosis of Kawasaki disease was made on the basis of the presence of all the major diagnostic criteria of Kawasaki disease. A favourable outcome was achieved 48 hours after the start of intravenous immunoglobulin and aspirin.

Discussion: Our case is of interest because of the presence of all the diagnostic clinical criteria as well as the favourable outcome achieved rapidly with treatment. In adults, the rarity of this disease, which frequently presents in the incomplete forms, with lack of specific clinical signs and the unavailability of diagnostic laboratory tests mean that diagnosis is usually delayed. It is recommended that treatment be initiated before the disease has progressed for 10 days.