Kawasaki disease associated with chickenpox: report of two sibling cases.

Kawasaki disease is a group of acute febrile illnesses of young children. Infectious etiology for Kawasaki disease has been long postulated, although no single causing agent has been identified consistently by conventional methods. This report described two sisters, soon after a primary infection by varicella-zoster virus, manifesting fever and muco-cutaneous lesions compatible with the feature of Kawasaki disease consecutively. Mild dilatation of the coronary artery was revealed in both by echocardiography. Both of them received intravenous gamma-globulin therapy and the follow-up echocardiography showed no further progression of the coronary lesion. We suggest the possibility of varicella-zoster virus as one of the triggering agents for Kawasaki disease in genetically susceptible individuals. The severe cardiac complication of Kawasaki disease may be prevented by early treatment if clinicians are alert to this possible association in those children with chickenpox exhibiting unusual muco-cutaneous lesions.