Kawasaki disease: Clustering in infants and pre-school children in Kuwait

We report five children who presented within a 2-month period and who all fulfilled at least four of the five criteria essential for the diagnosis of Kawasaki disease. They were three girls and two boys aged between 5 months and 3 years. Two of them had atypical, presentations; one mimicked infectious mononucleosis and the other had severe abdominal pain and was later found to have hydrops of the gall bladder. Although treatment was started within the 1st 10 days of the illness, echocardiographic changes were found in three cases: one had myocarditis and the other two showed changes in the coronary arteries. The occurrence of five cases in such a short period of time is similar to the clusterings of Kawasaki disease reported in Japan and the USA, and strongly suggests the presence of a causative infectious agent.