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Failure to respond to antibiotics and the later appearance of rash, conjunctivitis and a small coronary artery aneurysm on echocardiography led to the diagnosis of incomplete NFKD. This case underscores the importance of early consideration of incomplete or atypical KD criteria in children with persistent fever and lymphadenopathy unresponsive to antibiotics. Delaying diagnosis until full clinical criteria develop may increase the risk of coronary complications. Early use of cardiac biomarkers, echocardiography and awareness of incomplete KD criteria can help distinguish KD from BCL, enabling timely diagnosis and treatment to improve outcomes.<\/jats:p>","DOI":"10.1136\/bcr-2025-269493","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T18:15:38Z","timestamp":1764785738000},"page":"e269493","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Febrile convulsion and cervical lymphadenopathy as initial presentation of incomplete node-first Kawasaki disease"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4112-5961","authenticated-orcid":false,"given":"Muhammad","family":"Anjum","sequence":"first","affiliation":[{"name":"University Hospitals of Leicester NHS Trust, Leicester, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anjum","family":"Rafiq","sequence":"additional","affiliation":[{"name":"Northampton General Hospital NHS Trust, Northampton, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,12,3]]},"reference":[{"key":"2025120310153072000_18.12.e269493.1","doi-asserted-by":"crossref","first-page":"3117","DOI":"10.1093\/rheumatology\/kead051","article-title":"The incidence of Kawasaki disease using hospital admissions data for England 2006-2021","volume":"62","author":"Odingo","year":"2023","journal-title":"Rheumatology (Oxford)"},{"key":"2025120310153072000_18.12.e269493.2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001295"},{"key":"2025120310153072000_18.12.e269493.3","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2018-315087"},{"key":"2025120310153072000_18.12.e269493.4","doi-asserted-by":"crossref","unstructured":"You J . 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