BMJ Case Reports 2018; doi:10.1136/bcr-2018-224479
  • Reminder of important clinical lesson

Giant coronary artery aneurysms in a 12-week-old infant with incomplete Kawasaki disease

Open Access
  1. Robert Tulloh1,5
  1. 1 School of Clinical Sciences, University of Bristol, Bristol, UK
  2. 2 Department of Paediatric Surgery, Bristol Royal Hospital For Children, Bristol, UK
  3. 3 Department of Paediatrics, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
  4. 4 Department of Paediatric Rheumatology, Bristol Royal Hospital for Children, Bristol, UK
  5. 5 Department of Paediatric Cardiology, Bristol Royal Hospital For Children, Bristol, UK
  1. Correspondence to Dr Lucy Guile, lucyguile{at}
  • Accepted 14 March 2018
  • Published 28 March 2018


Kawasaki disease (KD) is an acute inflammatory vasculitis that occurs worldwide and disproportionately affects male children, most commonly between the ages of 6 months and 5 years. KD can present with only a few features and thus be difficult to diagnose, particularly in the youngest and oldest patients. We describe a 12-week-old Caucasian female infant who presented with rash and fever but no other features of KD, who developed giant coronary artery aneurysms. Considering how common is the presentation of a febrile infant with a rash, this case highlights the importance of considering KD early in the differential diagnosis for any infant with unexplained fever. Furthermore, it emphasises how echocardiography can help in the investigation of a febrile child with no clear source of infection.


  • Contributors LG wrote the initial draft. AK, SP and RT amended the draft and approved the final version. RT obtained the echocardiography images.

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

  • Competing interests None declared.

  • Patient consent Parental/guardian 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:

Open Access

Register for free content

The full text of all Editor's Choice articles and summaries of every article are free without registration

The full text of Images in ... articles are free to registered users

Only fellows can access the full text of case reports (apart from Editor's Choice) - become a fellow today, or encourage your institution to, so that together we can grow and develop this resource

Don't forget to sign up for content alerts so you keep up to date with all the case reports as they are published, and let us know what you think by commenting on the Editor's blog

Navigate This Article