Kawasaki disease without fever in a Costa Rican girl, first report from Central America

摘要

Dear Editor, We read with great interest the two recent papers on Kawasaki disease (KD) without fever published recently by Kato et al. [1] and Rodriguez-Lozano et al. [2]. We describe a girl with all classic KD symptoms except for fever, seen at the only pediatric tertiary referral and teaching hospital of Costa Rica. A 5-year-old girl was seen four times during a two-week period at the emergency outpatient clinic of our hospital, initially for a cervical lymphadenopathy for which oral amoxicillin was prescribed. She had no clinical improvement, and therefore, one dose of intramuscular benzathine penicillin was added 48 h after. She developed an ery-thematous skin rash, predominantly in the chest, trunk, neck, extremities, and genital area, and she was switched to oral cephalexin.