J Rheum Dis 2020; 27(1): 68-72  
Impending Cardiac Tamponade and Hemorrhagic Pleural Effusion as Initial Presentations of Incomplete Kawasaki Disease: A Case Report
Ye Ji Kim, M.D.1, Kyung Min Kim, M.D.1, Jae Young Lee, M.D., Ph.D.1, Ji Hong Yoon, M.D., Ph.D.1, Dae Chul Jeong, M.D., Ph.D.1, Woo Young Park, M.D.2, Gi Beom Kim, M.D., Ph.D.2
1Department of Pediatrics, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 2Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
Correspondence to: Ji Hong Yoon http://orcid.org/0000-0001-8498-2352
Department of Pediatrics, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea. E-mail:sirbe@naver.com
Received: September 30, 2019; Revised: October 22, 2019; Accepted: October 31, 2019; Published online: January 1, 2020.
© Korean College of Rheumatology. All rights reserved.

This is a open Access article, which permits unrestricted non-commerical use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Kawasaki disease (KD) is an acute febrile illness that is characterized by systemic inflammation usually involving medium-sized arteries and multiple organs during the acute febrile phase, leading to associated clinical findings. The diagnosis is based on the principal clinical findings including fever, extremity changes, rash, conjunctivitis, oral changes, and cervical lymphadenopathy. However, KD diagnosis is sometimes overlooked or delayed because other systemic organ manifestations may predominate in acute phase of KD. As a cardiovascular manifestation, an acute pericarditis usually shows a small pericardial effusion, but large pericardial effusion showing clinical signs of cardiac tamponade is very rare. Here, we described a case of incomplete KD presenting with impending cardiac tamponade, and recurrent fever and pleural effusion.
Keywords: Mucocutaneous lymph node syndrome, Pleural effusion, Cardiac tamponade


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