A Case Report of Atypical Kawasaki Disease Presenting with Persistent Fever and Hepatic Dysfunction

Background Kawasaki disease (KD) is an acute vasculitis of unknown etiology, primarily involving the coronary arteries. IVIG-resistant KD is associated with a significantly higher risk of coronary artery aneurysm (CAA), necessitating prompt treatment to suppress systemic inflammation. This report presents a case of IVIG-resistant KD complicated by cholestatic hepatitis, successfully managed with infliximab, though progression to a giant coronary aneurysm was observed. Case Presentation This case report describes a two-year-old male patient with Kawasaki disease (KD) who developed cholestatic hepatitis, a complication of the disease. Following the failure of both IVIG and corticosteroids, infliximab was administered, resulting in a notable clinical improvement. Nevertheless, despite treatment, a giant coronary artery aneurysm ultimately developed. Conclusion Infliximab was found to be an effective treatment for reducing systemic inflammation in this case of IVIG-resistant Kawasaki disease. Further studies are required to determine the optimal timing for infliximab administration in order to prevent severe cardiovascular complications.