LAUSR

Rationale: The diagnosis of Kawasaki disease (KD) is difficult and is often delayed for children whose age falls outside the typical age range of 6 months to 5 years, especially for those with incomplete KD (IKD) or atypical features. Patient concerns: A 2-month-20-day-old girl presented to our hospital with a chief complaint of intermittent fever for 1 day and 1 episode of seizure, with poor feeding and swelling of feet. Diagnosis: Until the appearance of red cracked lips, a diagnosis of IKD was considered. A rise in periungual desquamation of the hands confirmed the diagnosis. Interventions: Intravenous immunoglobulins were administered and aspirin and dipyridamole were used orally. Outcome: The temperature, C-reactive protein, and erythrocyte sedimentation rate returned to normal level and there was no coronary artery lesion. Lessons: This case highlights that the diagnosis of IKD should be considered in children whose primary presentation is fever and neurologic features, lacking principal clinical findings, particularly those <6 months of age.