Think kawasaki early: our experience from a case series

Background: Kawasaki disease (KD) is an acute febrile inflammatory vasculitis that mainly affects young children and is now the most common cause of acquired heart disease in the pediatric population globally. It predominantly affects children younger than 5 years of age and carries a significant risk of coronary artery involvement if untreated. Diagnosis remains challenging because of the absence of a specific diagnostic test, variable clinical presentation, and overlap with other inflammatory and infectious illness especially in the Indian context. Case Series: We report a series of five pediatric cases of Kawasaki disease, including both complete and incomplete forms in different age groups, youngest being 1 year and oldest of 8 years, presenting with varying clinical manifestations and cardiovascular involvement. Persistent fever, conjunctival congestion, mucosal changes, rash, cervical lymphadenopathy, and extremity changes were the predominant clinical findings. Echocardiography demonstrated coronary artery dilatation and myocardial dysfunction in several cases. Elevated inflammatory markers and NT-pro BNP levels and ECHO findings supported the diagnosis and assessment of disease severity. All patients received timely treatment with intravenous immunoglobulin (IVIG) and aspirin, while selected high-risk patients additionally received corticosteroids. All children showed clinical improvement following treatment, with rapid defervescence and stabilization or resolution of coronary abnormalities on follow-up echocardiography. Some patients exhibited incomplete features of Kawasaki disease making way for diagnostic dilemma and highlighting the need for heightened clinical awareness and suspicion. This case series highlights the diverse clinical spectrum of Kawasaki disease and underscores the importance of early recognition, prompt echocardiographic evaluation, and timely medical intervention in preventing coronary artery complications. It also emphasizes the importance of serial follow-up echocardiography to monitor the evolution or resolution of coronary artery abnormalities and to guide long-term management and prognosis