Capillary leak syndrome and aseptic meningitis in a patient with Kawasaki disease: A case report.

Medicine (Baltimore)

Second Department of Infectious Diseases, Xi'an Children's Hospital Department of Hepatobiliary Surgery, The 521 Hospital of China Ordnance Industry Outpatient Office, Xi'an Children's Hospital, Xi'an, Shaanxi Province, China.

Published: June 2018

Rationale: Kawasaki disease (KD) is an acute vasculitis of childhood, coronary complications are the most serious and classic complications of this disease. However, simultaneous complications such as systemic capillary leak syndrome (CLS) and aseptic meningitis are rarely reported.

Patient Concerns: A 19-month-old boy had continuous fever for 6 days, rash for 3 days, and somnolence for 1 day.

Diagnoses: The boy was diagnosed with KD presenting with SCLS and aseptic meningitis.

Interventions: He was treated with gamma globulin (2 g/kg) for 1 day, mannitol and furosemide to reduce intracranial pressure, human albumin to correct hypoproteinemia, methylprednisolone to control inflammation, and both aspirin and dipyridamole for anticoagulation.

Outcomes: After treatment, the patient recovered well. At one year follow-up, the patient was asymptomatic and showed no recurrence of skin rash.

Lessons: The incidence of KD has recently increased and cardiovascular complications are frequently reported. This may be combined with systemic damage, however, the combination of SCLS and aseptic meningitis is rarely reported, therefor, children who have SCLS, aseptic meningitis and unexplained fever >5 days, KD should be taken into account. Early diagnosis and timely treatment can reduce complications induced by KD.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5999480PMC
http://dx.doi.org/10.1097/MD.0000000000010716DOI Listing

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