Kawasaki Disease Complicated with Cerebral Vasculitis and Severe Encephalitis

Vesna D Stojanović; Tanja D Radovanović; Katarina M Koprivšek; Gordana V Vijatov Ðurić; Aleksandra D Doronjski

doi:10.4103/aian.AIAN_271_18

Kawasaki Disease Complicated with Cerebral Vasculitis and Severe Encephalitis

Ann Indian Acad Neurol. 2020 Mar-Apr;23(2):228-232. doi: 10.4103/aian.AIAN_271_18. Epub 2020 Feb 25.

Authors

Vesna D Stojanović¹, Tanja D Radovanović², Katarina M Koprivšek³, Gordana V Vijatov Ðurić⁴, Aleksandra D Doronjski⁵

Affiliations

¹ Faculty of Medicine, Institute for Child and Youth Health Care of Vojvodina, Intermediate Care Unit, University of Novi Sad, Novi Sad, Serbia.
² Faculty of Medicine, Institute for Child and Youth Health Care of Vojvodina, Intensive Care Unit, University of Novi Sad, Put Doktora Goldmana 4, Sremska Kamenica, Serbia.
³ Faculty of Medicine, Oncology Institute of Vojvodina, Diagnostic Imaging Centre, University of Novi Sad, Novi Sad, Serbia.
⁴ Department for Immunology, Faculty of Medicine, Institute for Child and Youth Health Care of Vojvodina, University of Novi Sad, Novi Sad, Serbia.
⁵ Faculty of Medicine, Institute for Child and Youth Health Care of Vojvodina, Intensive Care Unit and Neonatology, University of Novi Sad, Hajduk Veljkova 10, Novi Sad, Serbia.

Abstract

We report a case of a 7-year-old boy with Kawasaki disease (KD) complicated with cerebral vasculitis and encephalitis. The patient was admitted with signs of encephalopathy, seizures, and coma. The diagnosis of KD was made on the 2^nd day of hospitalization based on the clinical features (fever >5 days, maculopapular rash, nonpurulent conjunctivitis, fissured lips, and cervical adenopathy). Brain magnetic resonance imaging findings suggested cerebral vasculitis. Treatment with intravenous immunoglobulin was followed by mild improvement. After a single dose of immunoglobulin, pulse methylprednisolone therapy was started resulting in gradual improvement of consciousness and eventual complete motor and cognitive function recovery with regression of brain magnetic resonance lesions. KD can present with marked neurological symptomatology. Therefore, it should be considered in the differential diagnosis of encephalitis and encephalopathy etiologies in children.

Keywords: Cerebral vasculitis; Kawasaki disease; encephalitis.

Publication types

Case Reports