BMJ Case Reports 2017; doi:10.1136/bcr-2017-222323
  • Reminder of important clinical lesson

Safety netting versus overtreatment in paediatrics: viral infection or incomplete Kawasaki disease?

Open Access
  1. Edina Moylett3
  1. 1Department of Medicine, National University of Ireland—Galway, Galway, Ireland
  2. 2Department of Paediatrics, Letterkenny General Hospital, Letterkenny, Donegal, Ireland
  3. 3Department of Paediatrics, University College Hospital Galway, Galway, Ireland
  1. Correspondence to Dr Jennifer Michelle Charlesworth, charlesworth.jennifer{at}
  • Accepted 17 October 2017
  • Published 8 November 2017


Kawasaki disease (KD) is the most common systemic vasculitis of childhood. The following presentation of a 4-year-old Irish boy referred to a secondary care paediatric service from the community with prolonged fever, oral mucous membrane changes and painless blistering lesions of the hands and feet in the presence of elevated inflammatory markers serves as an opportunity to discuss the diagnostic criteria and treatment for KD and incomplete KD, an often missed diagnosis with significant paediatric morbidity outside an academic paediatric centre.


  • Contributors JMC and BP contributed to the acquisition and interpretation of data for the work; JMC and EM assisted with drafting the work or revising the manuscript critically for important intellectual content. JMC, BP and EM had final approval of the version to be published and are in agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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