Kawasaki Disease Presented with Meningitis in an Egyptian Adolescent

Kawasaki disease is an acute vasculitis of childhood. There is varying incidence among ethnic groups with higher rates among Asians. An Egyptian male adolescent 12 years old presented with fever, loss of appetite, nausea and vomiting for 3 days. He had convulsion on admission. Physical examination revealed positive meningeal signs. Treatment of meningitis was started with no response. On day 6 of fever maculopapular skin rash appeared as well as bilateral non purulent conjunctivitis. Laboratory tests were in support for incomplete Kawasaki disease but Echocardiography was normal. Intravenous immunoglobulin and aspirin were started with marvelous response. On 12th day of fever, skin desquamation appeared mainly on perineal area and on tips of fingers and toes. The patient was classified as risk level I, and his family was advised for counseling every 5 years. High index of suspicious is required for early diagnosis and management of Kawasaki disease irrespective of the clinical presentation or ethnicity. Early diagnosis can be a good prognostic index.