Atypical Manifestation of Kawasaki Disease Presenting as Acalculous Cholecystitis

Kawasaki disease (KD) can manifest with atypical presentations that may delay diagnosis. We report a case of a seven-year-old boy whose initial presentation was acute acalculous cholecystitis, a rare manifestation of KD. The patient presented with prolonged fever, abdominal pain, and sonographic evidence of gallbladder wall thickening. Despite initial antibiotic therapy for cholecystitis, the fever persisted. During hospitalization, the patient subsequently developed clinical features consistent with KD. Echocardiography revealed dilation of the left anterior descending coronary artery. The symptoms resolved following treatment with intravenous immunoglobulin, aspirin, and corticosteroids. This case highlights that KD may mimic acute cholecystitis and that evolving clinical features require prompt reassessment.