Beyond the Atypical: Gastrointestinal Manifestations in Kawasaki Disease

Kawasaki disease (KD) is an acute vasculitis mainly seen in children, with a specific risk for coronary artery involvement. Atypical symptoms can sometimes result in missed diagnoses, delaying necessary treatment and increasing the chances of serious cardiovascular complications. We report a case of a six-month-old previously healthy girl who had not been vaccinated. She presented with high fever, vomiting, and diarrhea for two weeks. The initial treatment for a suspected upper respiratory infection and later gastrointestinal issues created a diagnostic challenge. After many tests and scans over several weeks, a clear diagnosis was made only when an echocardiogram showed dilated coronary arteries and a dilated aortic root. She was then diagnosed with atypical KD and was given high doses of aspirin and intravenous immunoglobulins, resulting in substantial improvement in her condition. This case points out the difficulty in diagnosing KD in very young children, particularly when typical signs are missing. The delayed identification of KD led to serious complications, highlighting the importance of greater awareness among healthcare workers about atypical symptoms in infants. Quick action is vital to reduce the risk of severe cardiovascular consequences and to avoid delaying necessary treatment.