Ma Wei, Sun Juan, Wang Huaili
Department of Pediatric Intensive Care Unit, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Medicine (Baltimore). 2018 Dec;97(50):e13280. doi: 10.1097/MD.0000000000013280.
The diagnosis of Kawasaki disease (KD) is difficult and is often delayed for children whose age falls outside the typical age range of 6 months to 5 years, especially for those with incomplete KD (IKD) or atypical features.
A 2-month-20-day-old girl presented to our hospital with a chief complaint of intermittent fever for 1 day and 1 episode of seizure, with poor feeding and swelling of feet.
Until the appearance of red cracked lips, a diagnosis of IKD was considered. A rise in periungual desquamation of the hands confirmed the diagnosis.
Intravenous immunoglobulins were administered and aspirin and dipyridamole were used orally.
The temperature, C-reactive protein, and erythrocyte sedimentation rate returned to normal level and there was no coronary artery lesion.
This case highlights that the diagnosis of IKD should be considered in children whose primary presentation is fever and neurologic features, lacking principal clinical findings, particularly those <6 months of age.
川崎病（KD）的诊断较为困难，对于年龄不在6个月至5岁典型年龄范围内的儿童，尤其是不完全川崎病（IKD）或具有非典型特征的儿童，诊断往往会延迟。
一名2个月20天大的女孩因间歇性发热1天和1次惊厥就诊于我院，伴有喂养困难和足部肿胀。
在出现红唇皲裂之前，考虑诊断为IKD。手部甲周脱皮增多证实了诊断。
给予静脉注射免疫球蛋白，并口服阿司匹林和双嘧达莫。
体温、C反应蛋白和红细胞沉降率恢复正常，未出现冠状动脉病变。
该病例强调，对于以发热和神经系统特征为主、缺乏主要临床表现的儿童，尤其是年龄<6个月的儿童，应考虑IKD的诊断。
