Kawasaki Disease in Somalia; A Case Report and Literature Review

Abstract: Kawasaki disease (KD) is a prevalent form of vasculitis in childhood, primarily affecting infants and young children. This leads to persistent cardiovascular complications resulting from coronary artery damage. Despite various hypotheses, the exact cause of this disease remains unknown. We present a case of Kawasaki disease in a one-year-old boy who exhibited one week history of high fever, rash, and conjunctivitis. The clinical manifestations progress, beginning with fever during the acute phase. Subsequently, non-purulent bilateral conjunctival redness developed, followed by changes in the mouth, such as red and cracked lips, along with a reddish tongue (strawberry tongue). This was achieved by one-sided cervical lymphadenopathy (with one node exceeding 1.5 cm in diameter), and within five days of fever onset, polymorphous rashes emerged. The patient was diagnosed with typical Kawasaki disease, and treatment was initiated with acetylsalicylic acid at a dose of 50 mg/kg/day and intravenous immunoglobulin (IVIG) at a dose of 2 g/kg. The diagnostic criteria for Typical Kawasaki disease include both the Japanese working guidelines and the American Heart Association guidelines, which further categorize the disease as typical or atypical. Treatment with intravenous immunoglobulin (IVIG) and aspirin (ASA) during the acute phase significantly reduced the risk of coronary abnormalities by approximately 5%. In summary, Kawasaki disease is infrequently documented in sub-Saharan countries. The uncommon presentation and rarity of the disease pose challenges for diagnosis, particularly in sub-Saharan Africa, notably Somalia, where no cases have been reported to date.