Coronary artery dilatation associated with streptococcus pneumoniae infection misdiagnosed as coronary artery aneurysm: A case report

Abstract Kawasaki disease (KD) is the leading cause of coronary artery dilatation (CAD) in children. As clinicians tend to have an inadequate understanding of other febrile diseases that can caused CAD, febrile patients with CAD are easily misdiagnosed as KD and treated accordingly. Therefore, improving the understanding of CAD which is not caused by KD has important clinical significance for avoiding misdiagnosis as KD and improving the prognosis of patients. Although rare, various infections and inflammatory diseases can cause CAD. However, there are no reports of CAD caused by S. pneumoniae infection. We firstly report a case of invasive S. pneumoniae systemic infection and meningoencephalitis that was misdiagnosed as KD due to fever and CAD at the beginning of the disease, resulting in delayed treatment and serious neurological complications. These findings highlight the possibility of CAD due to non-KD causes and suggest that for febrile children with CAD, invasive S. pneumoniae infection should be considered as differential diagnosis. Furthermore, this case also has important clinical value in improving clinicians’ understanding of the involvement of S. pneumoniae infection in the cardiovascular system.