Errors in the diagnosis of Kawasaki syndrome in children are a clinical case

Background. Kawasaki syndrome is an acute systemic vasculopathy of unknown etiology, primarily affecting infants and preschool-aged children. Persistent fever, conjunctivitis, polymorphic rash, mucosal lesions, and lymphadenopathy are not pathognomonic symptoms, leading to a high risk of misdiagnosis and delayed diagnosis. As a result, patients are often initially hospitalized in infectious disease wards, where time is wasted on the laborious process of differential diagnosis with a wide range of bacterial and viral infections. Effective therapy is aimed at preventing lifethreatening complications, which directly depends on its timely initiation. The "gold standard" of treatment is the combined administration of intravenous immunoglobulin and acetylsalicylic acid within the first 7-10 days of illness. Delayed initiation of adequate therapy increases the risk of developing specific complications (coronary artery disease with the formation of aneurysms, stenosis, thrombosis, or vessel rupture), which become the leading cause of acquired coronary artery disease, myocardial infarction, and sudden death in children in the future.

Purpose: medical education to physicians on the issue of Kawasaki syndrome.

Materials and methods. Analysis of the hospital chart, clinical and anamnestic data, and laboratory and instrumental examination results of a 3-year-old patient with complete Kawasaki syndrome was conducted.

Results. A description of the symptoms and course of Kawasaki syndrome in a young child is presented through an analysis of the clinical situation and diagnostic errors made at the onset of the disease. The basis for the diagnosis of Kawasaki syndrome in our observation were: fever during antibacterial therapy for more than 5 days, the presence of a rash, changes in the oral mucosa, lymphadenitis, scleritis, erythema, and swelling of the extremities. This article may be of interest to primary care physicians for medical education on the topic of Kawasaki syndrome.

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