Acute appendicitis as the first presentation of Kawasaki Disease in a 5-year-old boy: case presentation and review of the literature

While Kawasaki Disease (KD) related mortality has been reduced due to the early recognition of its classic clinical features, acute abdomen remains a seldom KD presentation. Acute appendicitis in the context of KD is even rarer. Here, we present an interesting case of KD, demonstrated with appendicitis and a review of the existing literature. A 5-year-old boy was transferred to our hospital due to acute appendicitis and phlegmon, which did not respond to the conservative antibiotic treatment. He was constantly febrile and had demonstrated a maculopapular rash of the trunk and extremities, as well as hand, feet and eyelids' edema/conjunctivitis. KD was diagnosed and intravenous g-globin was administered to the patient, who demonstrated complete remission. Acute appendicitis in KD is an extremely rare entity, which may fatally delay the diagnosis. Pediatricians and surgeons should be aware of it, as its favorable course lies upon their clinical judgment.