We present the case of a child who initially presented with gastrointestinal symptoms suggestive of severe rotavirus gastroenteritis complicated by hyponatraemic dehydration. Appropriate intravenous fluid therapy was administered but the patient, still feverish, developed anasarca probably due to hyperpermeability of microvessels following massive inflammation. Atypical Kawasaki disease was diagnosed on the basis of the clinical findings and laboratory tests. An echocardiogram performed on the 14th day showed a coronary artery aneurysm of the right coronary artery and a generalised dilation of left coronary artery without pericardial effusion. Anasarca in Kawasaki disease has never been reported before in the literature. A rotavirus infection probably triggered the severe and atypical signs in the case reported here.
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