Kawasaki Disease: Sudden Death in Early Infancy from Accelerated Late Sequelae of Coronary Artery Aneurysms

Kawasaki disease is an acute, self-limited illness of young children (most commonly under 4 years of age) that may result in significant cardiovascular sequelae in about 20% of the patients 10 to 20 years later, mostly from occlusive coronary artery disease and myocardial infarction. Early mortality occurs in about 2% of children under the age of 2 years as the result of acute coronary vasculitis, with or without myocarditis, and of complications from coronary aneurysms. To our knowledge, fatal late sequelae of “healed” or “regressed” coronary aneurysms with occlusive intimal fibrocellular proliferation occurring in children under 1 year of age, have not been reported. We describe one such rare example in an 11-month-old infant.