No abstract

Background: Rising incidences of Kawasaki disease (KD) have been reported worldwide. Reported herein are the results of 4 triennial KD surveillances conducted in Ontario. Methods:Between 1995 and 2006 all hospitals in Ontario were asked on 4 occasions to identify all patients with discharge diagnoses of KD and report incident cases. Results:The latest surveillance identified 697 new KD patients (100% response rate) for a total of 2378 KD patients through all 4 surveillances. Yearly incidence was 26.2/100 000 for <5 years old, 6.7/100 000 for 5-9 years old and 0.9/100 000 for 10-14 years old. KD incidence significantly increased from 1995 to 2006, although the increase seemed to plateau between the 3rd and 4th surveillance. There was an increase in the proportion of patients diagnosed with incomplete KD and a significant reduction in the rate of coronary artery abnormalities, possibly due to better disease recognition and treatment. Hospitals reporting <20 cases per surveillance were found to be more likely to report cases with incomplete KD. These patients were also less likely to be treated with i.v. immunoglobulin and aspirin but were more likely to be treated with antibiotics, suggesting uncertainties regarding diagnosis and management of KD patients in those centers. Conclusions:The incidence of KD in Ontario is possibly one of the highest outside of Asia and has been rising since 1995. Although the most recent surveillance demonstrated improved cardiac outcomes, treatment delays or absence thereof continue to be a problem. Effective diagnosis and prompt treatment remain critical aspects of KD management.

The aim of this study was to define a comprehensive profile of patients at risk for a delayed diagnosis of Kawasaki disease (KD) including non-patient related variables such as caregiver behavior and health care providers' experience with KD.

Background: Rapidly involuting congenital hemangiomas (RICHs) are rare vascular tumors that have a proliferative phase in utero, present fully grown at birth, and have a fast involution phase after birth. Even rarer cases have completed involution in utero and present at birth as an atrophie plaque with redundant skin.Case Report: We present one case of a RICH that underwent involution in utero and revise the diagnostic and management implications.Contexte: Les hémangiomes congénitaux à involution rapide (HCIR) sont des tumeurs vasculaires rares, qui connaissent une phase de prolifération durant la vie intra-utérine, atteignent leur plein développement à la naissance et subissent une phase d'involution rapide après la naissance. Plus rares encore sont les cas d'învolution complète durant la vie intra-utérine, et les hémangiomes se présentent alors, à la naissance, sous forme de plaques atrophiées, accompagnées d'un surplus de peau.Exposé de cas: Sera présenté ici un cas d'HCIR dont la régression s'est produite durant la vie intra-utérine; nous en analyserons la portée sur les plans du diagnostic et de la prise en charge.