A case of Kawasaki disease initially diagnosed as septic shock

Abstract

A previously healthy 12-year-old boy was admitted to our hospital with distributive shock, liver failure, and non-oliguric renal failure. Initially, we suspected septic shock on the basis of laboratory studies, which showed high WBC, CRP, procalcitonin, and cytokine levels. However, echocardiography performed within 24 hr revealed decreased cardiac function, which led to the diagnosis of Kawasaki disease (KD). KD has been reported in all pediatric age groups, although 85% of patients were younger than 5 years. KD is a cytokine-associated disease, i.e., a systemic inflammatory response syndrome. The possibility of KD must be considered even when the patient's symptoms indicate distributive shock, as in this case.