A 9-year-old girl with Kawasaki disease and pulmonary nodules

Excerpt

A 9-year-old girl was referred for low-grade fever, posterior cervical pain, maculopapular rash, erythema of pharyngeal mucosa, and bilateral conjunctival injection on 28 January 2020. The remaining examination was unremarkable, including auscultation, meningeal irritation signs, cervical lymphadenopathy, and extremity changes. She and her family had no travel history. Laboratory data showed slightly elevated white blood cell (WBC) count 9.7 × 10⁹/L and C-reactive protein (CRP) levels 3.3 mg/L. She scheduled a follow-up visit for 3 days’ time but returned later that evening complaining of chest pain. A chest radiograph showed no apparent findings, and she went home. The next day, she revisited our hospital due to a high-grade fever, neck pain, and cough. Rapid antigen tests for group A streptococcus, adenovirus, and influenza A/B were negative. Repeated blood tests showed elevated WBC count 13.4 × 10⁹/L and CRP levels 82.0 mg/L; therefore, she was admitted for further examination. …