Facial nerve palsy presenting as rare neurological complication of Kawasaki disease A case report

Rationale: Facial nerve palsy (FNP) is one of the rare neurologic symptoms of Kawasaki disease (KD), associated with a higher incidence of coronary arteries lesions and may be an indicator of more severe disease. Patient concerns: A 3-month-old male infant with persistent fever, irritability, and facial asymmetry. Diagnoses: KD with FNP. Interventions: The infant received intravenous immunoglobulin (IVIG) (2 g/kg/16 hours) and aspirin (50 mg/kg/day) were started on the 8th day of illness. Outcomes: Fever and FNP resolved within 48hours after IVIG treatment. The inflammatory markers all improved to normal or nearnormal levels before discharge; all infectious studies returned negative. His left facial weakness was unappreciable at day of discharge. Lessons: FNP associated with KD is an uncommon finding but may indicate an increased risk of coronary artery involvement. KD should always be kept in mind in the differential diagnosis of a child who presents with prolonged unexplained fever, even with incomplete diagnostic features, as well as the need to be aware of unusual manifestations, such as FNP.