Timely Diagnosis of Kawasaki Disease Shock Syndrome Based on Positive Transthoracic Echocardiography.

Abstract

In this article, we describe a Kawasaki disease shock syndrome (KDSS) in a 14-year-old girl, who presented with a fever for 8 days and annular erythema on her back for 2 days. Mycoplasma pneumoniae antibodies were positive. Chest computed tomography showed no abnormalities in the lungs and mediastinum. Treatment with antibiotic drugs proved ineffective. The C-reactive protein(CRP) level was high, and the troponin I and N-terminal brain natriuretic peptide precursor (NT-proBNP) levels were significantly elevated. It was not until transthoracic echocardiography detected bilateral dilation of the coronary artery and right coronary artery diameter z score 3.16 (z score ≥ 2.5) on day 9 of the fever, which was consistent with the changes in Kawasaki disease, that the diagnosis of incomplete Kawasaki disease (IKD) and KDSS was made. Our aim is to accentuate the value of positive transthoracic echocardiography in the diagnosis of IKD and KDSS.