Concomitant Dengue fever and Kawasaki disease in an infant: case report and review of the literature

Kawasaki disease is a common childhood vasculitis of unknown aetiology, with infectious triggers often proposed. The association of Kawasaki disease with Dengue is rare. It often poses a diagnostic challenge owing to the close overlap of clinical features and a lack of diagnostic tests for Kawasaki disease. Concominant Dengue fever and Kawasaki disease in a 7-month-old boy is reported, and the possible association between the two conditions is considered. He presented with an acute febrile illness and was diagnosed with Dengue fever based on positive serology. Despite standard management for Dengue, he remained febrile and developed features suggestive of incomplete Kawasaki disease. Echocardiogram demonstrated a small coronary artery aneurysm. There was a dramatic response to intravenous immunoglobulin and aspirin. Follow-up at 6 weeks showed complete resolution of the aneurysm without residual cardiac sequelae. Kawasaki disease should be considered in children with Dengue who have persistent fever or evolving clinical features. Prompt recognition and treatment are essential to prevent coronary artery complications. The rare co-existence of Dengue and Kawasaki disease raises the question of whether this is a mere association or a potential trigger, highlighting an area for future research.