{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T15:23:41Z","timestamp":1769268221908,"version":"3.49.0"},"reference-count":9,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T00:00:00Z","timestamp":1692316800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,9,1]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Kawasaki disease (KD) is an acute systemic vasculitis which predominantly occurs in childhood but rarely in adulthood. Diagnosis relies on the presence of typical clinical features; however, patients may present atypically, increasing the challenge of timely diagnosis for physicians.<\/jats:p>\n <\/jats:sec>\n \n Case summary<\/jats:title>\n We report a case of a 40-year-old male presenting with persistent fever, rash, and unilateral neck swelling. Initial investigations were suggestive of necrotizing lymphadenitis, with a presumed infective aetiology. However, extensive microbiology and immunological investigations remained negative. Cardiac injury was evident with elevated troponin T and NT-proBNP; however, left ventricular systolic function was normal. After 4 days, clinical features consistent with KD were noted and the results of a lymph node biopsy supported this diagnosis. Despite timely treatment with intravenous immunoglobulins (IVIG) and high-dose aspirin, follow-up computed tomography (CT) coronary angiography demonstrated two sequential aneurysms (max 6\u2005mm) in the right coronary artery, plus one small subtle aneurysm in the proximal left anterior descending artery (4\u2005mm).<\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n Diagnosis of adult KD remains challenging, as symptoms often present sequentially over time rather than simultaneously and many of the clinical features necessary for diagnosis share commonality with other infectious disease processes.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytad397","type":"journal-article","created":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T15:43:48Z","timestamp":1692373428000},"source":"Crossref","is-referenced-by-count":2,"title":["Adult Kawasaki disease: a rare and challenging diagnosis\u2014a case report"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4615-7180","authenticated-orcid":false,"given":"Timothy","family":"O\u2019 Connor","sequence":"first","affiliation":[{"name":"Cardiology Department, Beaumont Hospital , Beaumont road, Dublin D09V2N0 , Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cora","family":"McNally","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department , Beaumont Hospital, Beaumont road, Dublin D09V2N0 , Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5071-6221","authenticated-orcid":false,"given":"Mark W","family":"Kennedy","sequence":"additional","affiliation":[{"name":"Cardiology Department , Beaumont Hospital, Beaumont road, Dublin D09V2N0 , Ireland"},{"name":"Royal College of Surgeons in Ireland , Dublin , Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,8,18]]},"reference":[{"key":"2023090617110754600_ytad397-B1","doi-asserted-by":"crossref","first-page":"b1514","DOI":"10.1136\/bmj.b1514","article-title":"Kawasaki disease","volume":"338","author":"Harnden","year":"2009","journal-title":"BMJ"},{"key":"2023090617110754600_ytad397-B2","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1007\/s11926-020-0882-1","article-title":"A comprehensive update on Kawasaki disease vasculitis and myocarditis","volume":"22","author":"Soni","year":"2020","journal-title":"Curr Rheumatol Rep"},{"key":"2023090617110754600_ytad397-B3","doi-asserted-by":"crossref","first-page":"e927","DOI":"10.1161\/CIR.0000000000000484","article-title":"Diagnosis, treatment, and long-term management of Kawasaki disease: a scientific statement for health professionals from the American Heart Association","volume":"135","author":"McCrindle","year":"2017","journal-title":"Circulation"},{"key":"2023090617110754600_ytad397-B4","doi-asserted-by":"crossref","first-page":"995","DOI":"10.1007\/s00431-017-2937-5","article-title":"Dissecting Kawasaki disease: a state-of-the-art review","volume":"176","author":"Dietz","year":"2017","journal-title":"Eur J Pediatr"},{"key":"2023090617110754600_ytad397-B5","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1016\/j.autrev.2015.11.010","article-title":"Kawasaki disease in adults: observations in France and literature review","volume":"15","author":"Fraison","year":"2016","journal-title":"Autoimmun Rev"},{"key":"2023090617110754600_ytad397-B6","doi-asserted-by":"crossref","first-page":"1259","DOI":"10.1016\/j.jpeds.2012.11.064","article-title":"Lymph-node-first presentation of Kawasaki disease compared with bacterial cervical adenitis and typical Kawasaki disease","volume":"162","author":"Kanegaye","year":"2013","journal-title":"J Pediatr"},{"key":"2023090617110754600_ytad397-B7","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1542\/peds.93.3.525","article-title":"Lymphadenitis as the dominant manifestation of Kawasaki disease","volume":"93","author":"Stamos","year":"1994","journal-title":"Pediatrics"},{"key":"2023090617110754600_ytad397-B8","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1111\/j.1440-1754.2008.01310.x","article-title":"Kawasaki disease with lymphadenopathy and fever as sole initial manifestations","volume":"44","author":"Kubota","year":"2008","journal-title":"J Paediatr Child Health"},{"key":"2023090617110754600_ytad397-B9","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1016\/j.jpeds.2009.11.042","article-title":"A severe form of Kawasaki disease presenting with only fever and cervical lymphadenopathy at admission","volume":"156","author":"Nomura","year":"2010","journal-title":"J Pediatr"}],"container-title":["European Heart Journal - 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