Kawasaki disease presenting with severe airway obstruction: a case report

Background: Kawasaki disease is an acute systemic vasculitis primarily affecting children, typically presenting with persistent fever, rash, conjunctival injection, and oral mucosal changes. Although pharyngeal involvement may occur, severe upper airway obstruction requiring mechanical ventilation is extremely rare. We report a pediatric case of Kawasaki disease manifesting primarily as epiglottitis and laryngeal obstruction. Case presentation: . The patient's condition stabilized after combination therapy with intravenous immunoglobulin, vancomycin, and aspirin. In the convalescent phase, thrombocytosis and desquamation of the fingertips and toes were observed, fulfilling the clinical diagnostic criteria for Kawasaki disease. Conclusion: Although Kawasaki disease rarely causes epiglottitis, it should be considered as a differential diagnosis in children presenting with fever, neck swelling, and laryngeal obstruction. Early recognition and prompt initiation of immunomodulatory therapy can effectively control disease progression and prevent unnecessary surgical intervention.