Clinical Aspects of Scrub Typhus Initially Misdiagnosed as Kawasaki Disease

To analyze the clinical characteristics of scrub typhus (ST) initially misdiagnosed as Kawasaki disease (KD) in children.
This study was conducted through a review of medical records of children with ST from March 2005 to June 2015.
Among 182 incomplete KD patients, 11 patients were ST. Red lips, strawberry tongue, and BCG site redness were not reported. Presence of eschars was reported in 5 patients. Group 1 patients (n = 6) were initially treated by using intravenous immunoglobulin (IVIG) and among them, one patient had an eschar after IVIG use. Group 2 patients (n = 5) were also initially diagnosed as KD but were not treated because eschar was detected in four patients before use of IVIG. One patient had no eschar but had a positive serologic test before IVIG use.
When children have symptoms similar to KD but without red lips and strawberry tongue, clinicians should search for an eschar and perform serologic tests for ST.