an acute thrombus formation in the left coronary artery of an atypical kawasaki patient

Kawasaki disease (kd) is a self-limited syndrome with serious heart complications, mostly seen in children of age 5-month to 4-year-old. kd needs to be diagnosed soon to start ivig within 10 days of starting symptoms to lower heart complications to 5 folds. our case, a 2-year-old boy presented with prolonged fever and pharyngeal erythema. in early evaluation, erythrocyte sedimentation rate (esr) was elevated, and after that, color doppler echocardiography with suspicion for kd was performed and showed aneurysm and thrombosis formation in the left coronary artery (lca). hence, intravenous immunoglobulin (ivig) was started for the patient concurrent with daily check of troponin i level. in this case report, we present remarkable echocardiographic findings of a patient with the delay in diagnosis of kd demonstrating an aneurysm and acute thrombus formation in lca.