We report the occurrence of the adult-onset type of Kawasaki disease (KD) with classic mucocutaneous manifestations of KD, cholestatic liver disease, multiple splenic infarcts, and residual multiple coronary artery dilatations in a previously healthy 14-year-old male adolescent 16 days after having received one dose of the BNT162b2 coronavirus disease 2019 (COVID-19) mRNA vaccine. First, the report serves to highlight the diagnostic challenges of adult-onset KD often resulting in therapeutic delay and the frequently reported occurrence of persistent cardiovascular sequelae. Second, the report emphasizes that the temporal association of KD with the administration of a COVID-19 vaccine will likely be a frequent constellation in the near future, raising questions of a causative association. While there is currently no evidence of such an association in persons above 5 years of age, large-scale vaccination of children below 5 years of age will require close surveillance of vaccine-related adverse events.

Bern University Hospital General Consent (GC) was granted by the patient and his parents for the use of routine clinical data in the medical record for research purposes. In addition, oral informed consent was obtained from the patient and his parents as required by the University Hospital for case reports. The Cantonal Ethics Committee, Bern, Switzerland, declared nonresponsibility.

C. A., N. S., A. D., M. V. K., M. G., and P. K. A. A. cared for the patient. C. A., A. D., and P. K. A. A. drafted the manuscript. M. G. performed and evaluated the cardiac imaging studies. All authors contributed to the final version of the manuscript.

Received: 01 July 2022

Accepted: 15 September 2022

Article published online:
23 November 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany