BMJ Case Reports 2018; doi:10.1136/bcr-2017-221456
  • Unusual presentation of more common disease/injury

A 3-month-old infant with atypical Kawasaki disease

Open Access
  1. Anchalee Wangjirapan
  1. Department of Pediatrics, Faculty of medicine, Lampang Hospital, Lampang, Thailand
  1. Correspondence to Dr Anchalee Wangjirapan, cherry_cmu{at}
  • Accepted 28 November 2017
  • Published 30 May 2018


We report a 3-month-old girl who presented with high-grade fever for 3 days. Her initial physical examination was normal. Investigation showed abnormal white cells in her urine. She was diagnosed with a urinary tract infection and received an antibiotic for 1 day. After that, she developed a generalised maculopapular rash over her body. An adverse drug reaction from the antibiotic was suspected, and the patient was referred to our hospital. On admission, she still had fever and was irritable. She was diagnosed with sepsis and given another broad-spectrum antibiotic for 2 days. However, her fever still persisted. An additional thorough physical examination showed redness of her BCG inoculation scar. Consequently, a diagnosis of Kawasaki disease (KD) was made. After she received intravenous immunoglobulin, her fever diminished straight away. This case highlights an unusual manifestation of KD in an uncommonly young age group.


  • Contributors AW: picked a topic, made an outline and revised the manuscript. NL and AW: researched and wrote the paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Gaurdian consent obtained.

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

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

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