DIAGNOSTIC CHALLENGES OF TYPICAL AND INCOMPLETE KAWASAKI DISEASE PRESENTING WITH PULMONARY AND URINARY FINDINGS: A CASE REPORT

Kawasaki disease (KD) is an acute vasculitis of child­hood that can present with typical mucocutaneous symp­toms or more atypical features, leading to diagnostic delays. Early recognition and treatment are crucial to prevent coronary artery complications. We report two pediatric cases highlighting the diagnostic challenges of KD. The first case involved a two-year-old boy with classic clinical features of KD accompanied by radiolo­gically confirmed segmental pneumonia. Despite initial antibiotic treatment, clinical deterioration occurred until KD was diagnosed and treated with intravenous immu­noglobulin (IVIG) and aspirin. The second case involved a seven-year-old girl presenting with incomplete KD fe­atures and concomitant pyuria, for which a urinary tract infection (UTI) was suspected. IVIG administration led to rapid clinical improvement in both cases, and subsequ­ent cardiac imaging revealed coronary artery changes, emphasizing the critical importance of timely diagnosis. These cases underline the necessity of considering KD in children with prolonged fever and atypical findings such as pulmonary involvement or pyuria. Awareness of atypical and incomplete presentations is essential to avoid misdiagnosis and prevent serious cardiovascular complications.