Characteristics of Kawasaki Disease in Infants Younger than Six Months of Age

Chang, Fu; Hwang, Betau; Chen, Sue Jean; Lee, Pi Chang; Meng, C. C.Laura; Lu, Jen Her

doi:10.1097/01.inf.0000202067.50975.90

Cited by 138 publications

(128 citation statements)

References 18 publications

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“…10 Given that the presence of CAD is a very restrictive and specific criterion of incomplete KD, the AHA has developed an algorithm with clinical and analytical criteria for the evaluation and treatment of patients in whom incomplete KD is suspected, which we have used as a gold standard in this study. As in other studies, 11 we have found a longer diagnostic delay in incomplete forms, which, in our case, has been 24 hours (7 versus 6 days) and that in incomplete forms could be related to a higher risk of developing CAD. In our series, CRP and albumin levels have been related to the risk of developing CAD, as observed in other studies.…”

Section: Discussionsupporting

confidence: 66%

Risk of coronary artery involvement in Kawasaki disease

2016

Arch Argent Pediat

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Section: Discussionsupporting

confidence: 66%

Risk of coronary artery involvement in Kawasaki disease

2016

Arch Argent Pediat

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“…In addition, unusual symptoms, including aseptic meningitis, appear to occur more frequently in this age group 9) . It is plausible that the infrequent occurrence of typical signs of KD in affected infants is secondary to an inadequate immune response, which results in the weak vas culitis phenomenon observed in this age group 10) . Alternative explanations for the occurrence of incomplete KD in infants include the effect of superan tigen neutralization by maternal antibodies, transferred via the placenta, or cross reaction of antibodies gene rated by frequent active immunization 10) .…”

Section: Discussionmentioning

confidence: 99%

Incomplete Kawasaki Disease in a 5-Month-Old Girl Associated with Cerebrospinal Fluid Pleocytosis and Epidural Fluid Collection

Kim

Lee

Han

2015

Pediatr Infect Vaccine

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Cases of incomplete Kawasaki disease (KD), wherein the patient does not fulfill the full diagnostic criteria for KD, are often detected in infants younger than 6 months of age. The clinical manifestations in infants with incomplete KD may resemble other infectious diseases, including meningitis. For this reason, clinicians may have difficulty differentiating incomplete KD from other infectious diseases in this population. Various neurological features are associated with KD, including aseptic meningitis, subdural effusion, facial nerve palsy, cerebral infarction, encephalopathy, and reversible corpus callosum splenial lesions on magnetic resonance imaging. We report a case of a 5-monthold girl with incomplete KD, associated with cerebrospinal fluid pleocytosis and an epidural fluid collection. Echocardiography indicated dilatation of the main coronary arteries. The girl made a complete recovery, with resolution of both the epidural fluid collection and coronary artery aneurysms. In this case, the child is well, and showed normal developmental milestones at the 7-month follow-up.

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“…1,7 Incomplete cases are patients who do not fulfill the diagnostic criteria but have fever and two or three criteria and often have coronary involvement; Case Challenge previous studies showed a higher incidence of coronary abnormalities in infants younger than 6 months. 1 The diagnosis of IKD is difficult because many other infectious and inflammatory conditions may mimic its manifestations, such as Epstein-Barr virus infection and scarlet fever.…”

Section: Discussionmentioning

confidence: 99%

“…6 The diagnosis in this age of group is difficult because the clinical picture is often incomplete and similar to other diseases. 7 …”

Section: Diagnosismentioning

confidence: 99%

A 2-Month-Old Male with Pyuria and Persistent Fever

Cotugno¹,

Aquilani²,

Manno³

et al. 2012

Pediatr Ann

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A 2-month-old male was admitted to the hospital because of 2 consecutive days of fever. On admission, the infant was febrile with normal skin turgor. Lung, heart, and abdomen were unremarkable at examination, and the only outstanding sign was a generalized macular rash on his trunk.Laboratory exams showed a white blood cell count (WBC) of 10,300/mm 3 , with 58.8% neutrophils, 27% lymphocytes, and 5.7% monocytes; 10.1 g/dL of hemoglobin; and an elevated level of C-reactive protein (CRP, 18.6 mg/dL).Urine analysis revealed pyuria (183 WBC/mcL). Sepsis related to a urinary tract infection was presumed, and intravenous ampicillin and gentamicin were started.Abdominal ultrasound and echocardiography were performed and revealed normal findings. Fever persisted on the third day in the hospital despite antibiotic therapy, and the overall condition of the patient became worse.Nonpurulent bulbar conjunctivitis appeared. Due to his fever, poor appetite, irritability, and signs of meningismus and opisthotonus, a lumbar puncture was performed after a magnetic resonance imaging (MRI) exam of the head was negative.Cerebrospinal fluid (CSF) examination showed mildly elevated protein level (63.2 mg/dL) with normal glucose concentration and no cells. His blood, CSF, urine, and stool cultures were negative. Virologic tests (human herpesvirus 6, cytomegalovirus, herpes simplex viruses 1 and 2, enterovirus, and Epstein-Barr virus) were all negative by polymerase chain reaction.Laboratory investigations showed an increment of inflammatory markers (CRP 27.1 mg/dL; fibrinogen 600 mg/ dL) and leukocytosis (31,100/mcL).On the fourth day, thrombocytosis (platelets 696,000/mcL) was detected. On the fifth day of admission, a lab test was performed and revealed the diagnosis.

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Characteristics of Kawasaki Disease in Infants Younger than Six Months of Age

Cited by 138 publications

References 18 publications

Risk of coronary artery involvement in Kawasaki disease

Risk of coronary artery involvement in Kawasaki disease

Incomplete Kawasaki Disease in a 5-Month-Old Girl Associated with Cerebrospinal Fluid Pleocytosis and Epidural Fluid Collection

A 2-Month-Old Male with Pyuria and Persistent Fever

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