Kawasaki disease (KD) is an acute systemic vasculitis of unknown etiology that affects infants and young children but is extremely rare in neonates, especially afebrile KD. We present a case of KD without fever in a neonate and review the literature on KD in neonates. A newborn female was hospitalized because her peripheral blood leukocytes increased for half a day. The admission diagnosis was considered neonatal sepsis and bacterial meningitis. She had no fever since the admission, but a rash appeared on her face by the 7th day. On day 11 after admission, there was a desquamation on the distal extremities. On day 15 after admission, ultrasound showed non-suppurative cervical lymphadenopathy. Echocardiogram revealed coronary artery aneurysms in both sides. Finally, the patient was diagnosed with incomplete KD (IKD). The follow-up echocardiogram showed that the internal diameter of both coronary arteries returned to normal three months after birth. Fever, rash, and distal extremity desquamation during the recovery phase are the most common symptoms of IKD. When newborns present with clinical manifestations such as rash, distal extremity desquamation and cervical lymph adenitis and with an increased peripheral blood leukocyte count and progressive increase in platelets simultaneously, the medical staff should be highly alert to the possibility of KD even without fever. The echocardiogram needs to be performed promptly. The incidence of coronary artery lesions is significantly higher if neonatal KD patients miss timely diagnosis and treatment.

中文翻译：

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新生儿川崎病一例报告及文献复习

川崎病（KD）是一种病因不明的急性系统性血管炎，影响婴儿和幼儿，但在新生儿中极为罕见，尤其是无发热的川崎病。我们介绍一例新生儿不发热的川崎病病例，并回顾有关新生儿川崎病的文献。一名新生女婴因末梢血白细胞升高半天住院。入院诊断为新生儿败血症和细菌性脑膜炎。入院后没有发烧，但第7天脸上出现皮疹。入院第11天，出现四肢远端脱屑。入院后第15天，超声检查显示非化脓性颈部淋巴结肿大。超声心动图显示双侧冠状动脉瘤。最终，患者被诊断为不完全性KD（IKD）。随访超声心动图显示，出生三个月后双侧冠状动脉内径恢复正常。恢复阶段的发烧、皮疹和肢体远端脱屑是 IKD 最常见的症状。当新生儿出现皮疹、肢体远端脱屑、颈淋巴结炎等临床表现，且外周血白细胞计数升高、血小板同时升高时，即使不发热，医护人员也应高度警惕川崎病的可能。需要立即进行超声心动图检查。新生儿川崎病患者如果得不到及时诊断和治疗，其冠状动脉病变的发生率会显着升高。