Sudden unexpected death in an infant due to a ruptured coronary aneurysm revealing Kawasaki disease]

The early mortality of Kawasaki disease is low, resulting from coronary complications, mainly aneurismal thrombosis with myocardial infarction. The aneurysmal rupture is an exceptional cause of death. CASE REPORT: We report on a six-month-old girl who died suddenly and unexpectedly. The autopsy showed a cardiac tamponade caused by an important ruptured aneurysm of the left coronary artery. Multiple aneurysms, with or without thrombosis, on the right coronary were also present. There was no ischaemic lesion. Three weeks before death, this infant demonstrated several clinical signs of Kawasaki disease whose diagnosis had not been done. CONCLUSION: Even if the rupture of coronary aneurysm is an exceptional initial complication of Kawasaki disease, a better knowledge of the atypical or incomplete forms, particularly below the age of one year, should allow an early diagnosis and treatment, decreasing the risks of coronary complications. This observation furthermore illustrates the interest of post-mortem examination in all sudden or unexpected infant deaths.