Autopsy report of a sudden infant death that was strongly suspicious of Kawasaki disease

We conducted an autopsy on a 3-month-old boy in whom Kawasaki disease (KD) was strongly suspected based on the autopsy findings. The infant had a fever and was brought to a nearby clinic, where he was prescribed antipyretics and kept under observation. However, 15 days after onset of the fever, he s...

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Bibliographic Details
Published in:Pathology international 2024-07, Vol.74 (7), p.408-414
Main Authors: Yokouchi, Yuki, Asakawa, Nanae, Iwase, Hirotaro, Nasu, Takeshi, Takahashi, Kei
Format: Article
Language:English
Subjects:
Aneurysm
Aneurysms
Autopsies
Autopsy
Conjunctiva
Coronary artery
Coronary vessels
Fever
Infant mortality
Infants
Kawasaki disease
Leukocytes (neutrophilic)
Macrophages
Mortality
Mucocutaneous lymph node syndrome
Myocardial infarction
Occlusion
Pulmonary artery
Renal artery
SIDS
Splenic artery
Sudden infant death syndrome
Vasculitis
Veins & arteries
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Summary:We conducted an autopsy on a 3-month-old boy in whom Kawasaki disease (KD) was strongly suspected based on the autopsy findings. The infant had a fever and was brought to a nearby clinic, where he was prescribed antipyretics and kept under observation. However, 15 days after onset of the fever, he suddenly died in bed. He exhibited no obvious redness of the lips, tongue, or conjunctiva. Membranous desquamation was present on his distal fingers. Vasculitis was observed in the coronary arteries, renal artery, splenic artery, and pulmonary vein. In addition, coronary artery aneurysms were present in the right coronary artery and left anterior descending artery. Thrombotic occlusion was observed in one aneurysm in the right coronary artery, resulting in acute myocardial infarction. The coronary artery wall showed infiltration of numerous macrophages and neutrophils. This case was classified as incomplete KD because the coronary artery aneurysm could not be demonstrated before death and was only recognized at autopsy. Pathologists and forensic scientists need to be aware that there are cases in which KD goes undiagnosed and untreated, leading to coronary artery aneurysm formation and sudden death.
ISSN:1320-5463
1440-1827
1440-1827
DOI:10.1111/pin.13437