Clinical Significance of Bacille Calmette-Guerin Inoculation Site Erythema in Incomplete Kawasaki Disease

Abstract

Kawasaki disease is an acute systemic vasculitis occurring mainly in infants and children. It is considered a clinical diagnosis, diagnosed by a set of clinical criteria. When the needed criteria to make the diagnosis are not met, a diagnostic dilemma occurs that might contribute to a delay in the diagnosis and treatment, hence increasing the risk of its most feared complication, namely coronary artery aneurysm. This is particularly true in infants, who tend to have the incomplete as well as complicated form of the disease. This is why having additional specific and reliable clinical clues to the diagnosis can be of great value. We present an 8-month-old boy, who presented with a 4-day history of fever and fulfilled three out of the five clinical criteria needed to make the diagnosis of Kawasaki disease; however, due to the presence of Bacille Calmette-Guerin (BCG) inoculation site erythema, the delay in the diagnosis and treatment was avoided. The medical literature lacks sufficient research regarding the usefulness of this sign in Kawasaki disease. This study aims to emphasize on the importance of the erythema around the BCG inoculation site in the diagnosis of the challenging cases of incomplete Kawasaki disease, mainly in infants.




Int J Clin Pediatr. 2015;4(2-3):158-161
doi: http://dx.doi.org/10.14740/ijcp211w