Kawasaki disease is a generalized systemic vasculitis that affects blood vessels throughout the body. The aetiology of Kawasaki disease is still unknown but is thought to be related to the combined effects of the immune response, genetic susceptibility, and infections including COVID-19. In this case report, we present a seven months old male infant who presented to us with fever, swollen lips, ulcers in the mouth, enlarged tonsils, strawberry tongue, conjunctivitis and generalised non-blanchable maculopapular rash. The detailed workup fulfilled the criteria of Kawasaki disease. The COVID-19 IgM antibodies were positive. The patient was treated with IV Immunoglobulins, IV methylprednisolone and Aspirin. The repeat echocardiography on six weeks follow-up turned out normal. In conclusion, there should be a high index of suspicion of Kawasaki disease while evaluating pediatric patients with COVID-19 infection so that timely intervention can be made to prevent complications. Prospective studies are needed to evaluate the relationship between Kawasaki Disease and COVID-19 infection.
doi: https://doi.org/10.12669/pjms.39.2.6359
How to cite this: Tahir M, Mehmood R, Ahmad MS. Complete Kawasaki disease after COVID-19 infection in an infant. Pak J Med Sci. 2023;39(2):---------. doi: https://doi.org/10.12669/pjms.39.2.6359
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objective: To demonstrate the advantages and oncological safety of the submental flap.
Study Design: Case series.
Place and Duration of Study: Department of Plastic and Reconstructive Study, Combined Military Hospital Rawalpindi, Multan and Peshawar Pakistan, from Jul 2014 to May 2020.
Methodology: Twenty patients underwent flap reconstruction with a submental flap. The patients were diagnosed with squamous cell carcinoma, basal cell carcinoma and verrucous carcinoma at different sites of the head and neck. Only patients with no cervical lymph node metastasis were included.
Results: We operated a total of 20 patients, out of which 11 (55%) were male and 9 (45%) were female. The mean age was 62.75 years (range: 47-80 years). Thirteen (65%) patients were diagnosed with Squamous cell carcinoma, 5 (25%) with Basal cell carcinoma and 2 (10%) were diagnosed with Verrucous carcinoma on histopathology. Two (10%) patients reported back with regional recurrence and were given postoperative radiotherapy. One (5%) patient had complete flap loss while 2 (10%) had distal tip necrosis.
Conclusion: In carefully selected cases submental flap is a viable option, without the risk of occult metastasis.
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