BACKGROUND AND OBJECTIVE: Kawasaki disease is an acute febrile vasculitis of childhood. Infection is probably considered as a predisposing factor. According to low incidence of Kawasaki disease following the herpes simplex virus and to reduce mortality by early diagnosis and treatment of disease, a rare case of a patient with this disease will be introduced.

CASE REPORT: A 6-year-old male patient with fever, vomiting, decreased level of consciousness referred to the Tehran Children Medical Center. The patient had gradually loss of consciousness responding to painful stimuli and fever has been significant. He was treated with vancomycin and cefotaxime and acyclovir. After three days, the patient experienced partial recovery and lumbar puncture was done. PCR was done on cerebrospinal fluid which was positive for herpes virus type 1. During treatment the patient was suffered from scaling in the end of the fingers. Kawasaki disease was diagnosed and treated by measuring the levels of troponin, and echocardiography.

CONCLUSION: Due to the unusual symptoms of the kawasaki disease, taking into account the differential diagnosis of patients with febrile and non-febrile patients, even in the convalescent phase of infectious diseases is essential for early diagnosis and treatment.