# An Interesting Case of Refractory Kawasaki Disease With Co-infection

## TL;DR

A three-year-old child with persistent fever showed refractory Kawasaki disease along with a Klebsiella infection, requiring additional treatment for recovery.

## Contribution

This case highlights the coexistence of refractory Kawasaki disease and infection, emphasizing the need for comprehensive treatment approaches.

## Key findings

- The patient's fever persisted despite initial IVIG treatment, indicating refractory KD.
- A Klebsiella pneumoniae infection was identified and treated with antibiotics and corticosteroids.
- The child showed clinical improvement after receiving a second IVIG dose and corticosteroids.

## Abstract

Kawasaki disease (KD), formerly called mucocutaneous lymph node syndrome, is one of the common vasculitides of childhood. KD most commonly occurs in children over six months up to five years of age, although it can occur in young infants, older children, and adults. Early diagnosis is critical to achieving optimal treatment. We present a case of a three-year-old female child who was admitted with a fever for five days and fulfilled the diagnostic clinical criteria for KD. She was given intravenous immunoglobulin (IVIG) and aspirin. However, the fever persisted, and a urine culture showed the growth of Klebsiella pneumoniae. We started an antibiotic based on her sensitivity. Since fever spikes were not subsiding, she was given a repeat dose of IVIG along with an oral corticosteroid for refractory KD, after which she showed clinical improvement. This case highlighted that refractory KD can coexist with infection.