Journal of Medical Council of Iran
Volume 44, Issue 1 (2026)
jmciri 2026, 44(1): 68-73 |
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Ethics code: IR.TUMS.CHMC.REC.1404.147
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Yousefi S, Eshaghi H, Khodabandeh M. Kawasaki Disease with Concurrent BCGitis, Urethritis, and Conjunctivitis: A Diagnostic Challenge. jmciri 2026; 44 (1) :68-73
URL: http://jmciri.ir/article-1-3421-en.html
URL: http://jmciri.ir/article-1-3421-en.html
Pediatric Infectious Diseases Subspecialist, Children’s Medical Center, Tehran University of Medical Sciences, Pediatric Center of Excellence, Tehran, Iran
Abstract: (139 Views)
Abstract
Background: Kawasaki disease is one of the most common pediatric vasculitis, which, if left untreated, can lead to serious cardiac complications such as coronary artery aneurysms. Diagnosis of this disease is particularly challenging, particularly when atypical features are present. Findings such as inflammation at Bacillus Calmette–Guérin (BCG) vaccination site (BCGitis) and sterile urethritis, though not part of the
Case Report: A 10-month-old male infant was referred with five days of persistent fever, bilateral non-purulent conjunctivitis, erythematous lips, generalized maculopapular rash, inflammation at the BCG vaccination site, and sterile urethritis. Laboratory findings revealed elevated inflammatory markers, thrombocytosis, mild anemia, sterile pyuria, and mildly elevated liver enzymes. Initial echocardiography was reported as normal. Based on persistent fever, three principal clinical criteria, and the presence of supportive laboratory findings, Kawasaki disease was diagnosed. Treatment with IVIG and aspirin led to rapid improvement.
Conclusion: In febrile infants, the presence of principal criteria together with less common findings such as BCGitis and sterile urethritis may facilitate early diagnosis and timely treatment of Kawasaki disease, thereby reducing the risk of cardiac complications.
Background: Kawasaki disease is one of the most common pediatric vasculitis, which, if left untreated, can lead to serious cardiac complications such as coronary artery aneurysms. Diagnosis of this disease is particularly challenging, particularly when atypical features are present. Findings such as inflammation at Bacillus Calmette–Guérin (BCG) vaccination site (BCGitis) and sterile urethritis, though not part of the
Case Report: A 10-month-old male infant was referred with five days of persistent fever, bilateral non-purulent conjunctivitis, erythematous lips, generalized maculopapular rash, inflammation at the BCG vaccination site, and sterile urethritis. Laboratory findings revealed elevated inflammatory markers, thrombocytosis, mild anemia, sterile pyuria, and mildly elevated liver enzymes. Initial echocardiography was reported as normal. Based on persistent fever, three principal clinical criteria, and the presence of supportive laboratory findings, Kawasaki disease was diagnosed. Treatment with IVIG and aspirin led to rapid improvement.
Conclusion: In febrile infants, the presence of principal criteria together with less common findings such as BCGitis and sterile urethritis may facilitate early diagnosis and timely treatment of Kawasaki disease, thereby reducing the risk of cardiac complications.
Keywords: Kawasaki disease, BCGitis, sterile urethritis, non-purulent conjunctivitis, infant, vasculitis
Type of Study: case report |
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