Concurrent Kawasaki Disease and Stevens-Johnson Syndrome in an 18-Month-Old with Uncontrolled Inflammation
-
By
-
Catherine Deffendall
-
Jodi Backalar
-
Elizabeth Acevedo Zapata
-
Adriana Della Porta
-
Lorin Bibb
-
Tyler Reese
-
Charlotte M. Brown
-
June 10, 2026
Clinical Scorecard: Concurrent Kawasaki Disease and Stevens-Johnson Syndrome in an 18-Month-Old with Uncontrolled Inflammation
At a Glance
| Category | Detail |
|---|
| Condition | Kawasaki Disease and Stevens-Johnson Syndrome |
| Key Mechanisms | Uncontrolled inflammation leading to systemic symptoms and skin manifestations. |
| Target Population | Pediatric patients, particularly those with underlying genetic conditions. |
| Care Setting | Pediatric intensive care unit |
Key Highlights
- Patient presented with fever, rash, and oliguria after immunizations.
- Developed hypotension and required vasopressor support.
- Received IVIG and anakinra for presumed Kawasaki disease.
- Skin biopsy suggested possible Stevens-Johnson syndrome or toxic epidermal necrolysis.
- Complex presentation with coagulopathy and respiratory failure.
Guideline-Based Recommendations
Diagnosis
- Consider Kawasaki disease in febrile children with rash and systemic symptoms.
- Evaluate for Stevens-Johnson syndrome in patients with skin desquamation and systemic illness.
Management
- Initiate IVIG and consider anakinra for Kawasaki disease.
- Manage coagulopathy and respiratory failure as per standard protocols.
Monitoring & Follow-up
- Monitor vital signs and laboratory parameters closely in ICU.
- Regular dermatological assessments for skin changes.
Risks
- Risk of progression to severe Kawasaki disease with cardiovascular complications.
- Potential for severe skin reactions leading to SJS or TEN.
Patient & Prescribing Data
Children with Kawasaki disease and concurrent skin reactions.
Combination of antibiotics and immunomodulatory therapy may be necessary.
Clinical Best Practices
- Early recognition of Kawasaki disease symptoms is crucial.
- Multidisciplinary approach involving rheumatology and infectious disease specialists.
- Careful monitoring for adverse effects of treatments.
Related Resources & Content
