Cerebral and coronary vasculitis following meningococcal meningitis: an incomplete form of Kawasaki disease. A case report

Abstract

We present the case of a 7-month-old-child with confirmed meningococcal B meningitis. Despite adequate antibiotherapy fever persisted for more than 5 days. Echocardiographic examination and laboratory findings were suggestive of incomplete Kawasaki disease. Moreover, magnetic resonance imaging of the brain showed cerebral vasculitis. The fever subsided after 2 doses of immunoglobulins and a course of glucocorticosteroids.

Our case demonstrates that, even with a confirmed bacterial diagnosis, Kawasaki disease should be considered in the differential diagnosis when fever persists. Our case also demonstrates that procalcitonin may be helpful to differentiate an uncontrolled infection from inflammation.