Aseptic Meningoencephalitis in Children with Kawasaki Disease

Objective: To describe the clinical presentations, diagnosis and therapy of 15 Kawasaki disease (KD) patients with aseptic meningoencephalitis. Methods: Patients' medical records were retrospectively reviewed with reference to age, gender, duration of disease, clinical presentation, laboratory findings, diagnosis and therapy. Results: There were 10 males and 5 females with an average age of 38.2 months. Headache was noted in 10 patients (66.67%), vomiting in 6 (40.0%), seizures in one (6 67%). Thirteen (86.67%) showed central nervous system (CNS) features in the acute phase while 2 patients showed headache or vomiting in the subacute phase. Elevated C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were noted in all patients, thrombocytosis in 9 (60.0%), elevated aminoleucine transferase and/or aspartate aminotransferase in 2. Also, CSF pleocytosis were noted in 9 patients. These patients had a good response to intravenous immunoglobulin (IVIG) therapy. No complications were noted in the follow-up. Conclusion: KD, like many other vasculitic diseases, can sometimes involve the CNS and present with irritability, lethargy, headache, vomiting and seizures. Aseptic meningoencephalitis should be suspected especially in KD patients with persisted elevated CRP, ESR, and CNS symptoms.