Atypical Case of COVID-19 Associated Kawasaki Disease in an Eight-Year-Old Pakistani Boy

Abstract

People of all age groups have been affected worldwide during the coronavirus disease 2019 (COVID-19) pandemic. While the global efforts of researchers, clinicians, and scientists are underway, cases involving multiple systems with a wide range of presentations are on the horizon. As health organizations have started warnings about unusual manifestations of a Kawasaki disease (KD)-like inflammatory syndrome associated with COVID-19, some pediatric cardiologists noted that even classic cases are likely going undercounted. Here we report a case of a previously healthy eight-year-old Pakistani boy who presented with a four-day history of low-grade fever. The patient was admitted and diagnosed with COVID-19-associated atypical KD in the setting of fever for more than five days, maculopapular eruptions, and mild conjunctivitis. He screened positive for COVID-19 with an immunoglobulin G titer of 2.1 plus ruling out other childhood illnesses. He was managed with intravenous immunoglobulins and aspirin with gradual resolution of symptoms. His initial echocardiogram was unremarkable. He was discharged home on day six with a follow-up at two weeks.

Keywords: covid-19; kawasaki disease; mucocutaneous lymph node syndrome; sars-cov-2; vasculitis.

Figure 1. Chest x-ray posteroanterior view showing left upper lobe dense area of parenchymal opacification in addition to pleural effusion involving left lower lobe

Figure 2. Chest x-ray posteroanterior view showing patchy infiltrates in the right middle lobe

Figure 3. Daily temperature graph of the patient during hospital stay