Abstract
The clinical features of typical Kawasaki disease (KD) are well known and complications such as hydrops of the gallbladder, arthritis and aseptic meningitis have also been commonly described. Epididymo-orchitis is an extremely rare manifestation of Kawasaki Disease and there has only been, from our literature search, one report by Connolly in 1979. We describe the clinical presentation and management of a five-year-old boy with recurrent KD complicated by epididymo-orchitis. The patient was diagnosed with atypical KD and subsequently developed coronary aneurysms. He was treated with intravenous immunoglobulin, recovered well, and was placed on maintenance warfarin and aspirin. In the next two years, he developed two relapses. He presented four days after apparent remission of his 2nd recurrence with acute left testicular pain. This responded dramatically to intravenous hydrocortisone, and his symptoms abated within 24 hours. The occurrence of epididymo-orchitis in KD, along with the use of steroids in the treatment of extra-cardiac manifestations, is highlighted in this report. As this is a rare complication of KD, treatment protocols have not been widely formulated. Further studies to elucidate the immuno-pathogenesis of this manifestation would be necessary to define the role of steroids and to establish further treatment strategies for this interesting manifestation.
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Lim, D., Shek, L., Lee, B. et al. Epididymo-orchitis in a Patient with Atypical Kawasaki Disease - The Role of Steroids. Pediatr Res 53, 178 (2003). https://doi.org/10.1203/00006450-200301000-00149
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DOI: https://doi.org/10.1203/00006450-200301000-00149
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