PERSISTENT FEVER, MALAISE, CONJUNCTIVITIS, AND MILD CHEILITIS: WHEN ADENOVIRUS IS INVOLVED

A 5-and-a-half-year-old child presents with a 10-day history of fever, upper respiratory tract inflammation, conjunctivitis and diarrhoea. Clinical examination reveals inflammatory signs in the pharyngeal, ocular and tympanic areas, but no rash or peripheral skin changes. Kawasaki disease (KD) is initially suspected but later ruled out thanks to a normal echocardiogram and rapid clinical improvement. The diagnosis is confirmed as an adenovirus infection through PCR testing on nasopharyngeal aspirate and blood. Adenovirus can mimic KD with symptoms such as prolonged fever, conjunctivitis and pharyngitis, but subtle clinical differences help guide the differential diagnosis.