Appendicitis in an Infant with Atypical Features.

Acute appendicitis is an uncommon and challenging disease in infancy. Usually, the clinical presentation in neonates and infants is non-specific and varies depending on the age of the child and duration of the disease. Diagnosis of incomplete and atypical Kawasaki disease (KD) in infants is also a challenging aspect and there is no gold standard for this diagnosis and sometimes fever is the only symptom that could be found. Herein, we report a 6-month infant with a 7 days of fever and bilateral pleural effusion, elevated erythrocyte sedimentation rate, thrombocytosis, hypo-albominemia, normal abdominal ultrasound, and primary diagnosis of KD. Final diagnosis was perforated retrocecal appendicitis and abscess formation. Physicians should be aware of the vague signs and symptoms of acute appendicitis in neonates and infants and consider this diagnosis to prevent delayed diagnosis, inappropriate treatment, and consequent morbidity and mortality.