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      Profile of Children with Kawasaki Disease Associated with Tropical Infections

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Objective

          To describe various infectious triggers for Kawasaki disease (KD) in India.

          Methods

          A series of 10 children with diagnosed infections who developed KD during their course of illness has been presented. They were diagnosed by the American Heart Association (AHA) 2017 guidelines. Echocardiography was done to check for coronary artery dilation. Treatment was instituted as per standard protocol.

          Results

          Kawasaki disease was diagnosed in 8 boys and 2 girls, aged 1 mo to 11 y. These children were being treated for dengue, chikungunya, SARS-CoV-2, hepatitis A, tuberculosis, brucellosis, disseminated staphylococcal sepsis, scrub typhus, and enteric fever.

          Conclusions

          Kawasaki disease has been associated with infectious triggers. It should be considered in febrile patients with mucocutaneous involvement or in nonresponsive sepsis, despite adequate therapy.

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          Most cited references33

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          An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: an observational cohort study

          Lucio Verdoni, Angelo Mazza, Annalisa Gervasoni … (2020)
          Summary Background The Bergamo province, which is extensively affected by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic, is a natural observatory of virus manifestations in the general population. In the past month we recorded an outbreak of Kawasaki disease; we aimed to evaluate incidence and features of patients with Kawasaki-like disease diagnosed during the SARS-CoV-2 epidemic. Methods All patients diagnosed with a Kawasaki-like disease at our centre in the past 5 years were divided according to symptomatic presentation before (group 1) or after (group 2) the beginning of the SARS-CoV-2 epidemic. Kawasaki- like presentations were managed as Kawasaki disease according to the American Heart Association indications. Kawasaki disease shock syndrome (KDSS) was defined by presence of circulatory dysfunction, and macrophage activation syndrome (MAS) by the Paediatric Rheumatology International Trials Organisation criteria. Current or previous infection was sought by reverse-transcriptase quantitative PCR in nasopharyngeal and oropharyngeal swabs, and by serological qualitative test detecting SARS-CoV-2 IgM and IgG, respectively. Findings Group 1 comprised 19 patients (seven boys, 12 girls; aged 3·0 years [SD 2·5]) diagnosed between Jan 1, 2015, and Feb 17, 2020. Group 2 included ten patients (seven boys, three girls; aged 7·5 years [SD 3·5]) diagnosed between Feb 18 and April 20, 2020; eight of ten were positive for IgG or IgM, or both. The two groups differed in disease incidence (group 1 vs group 2, 0·3 vs ten per month), mean age (3·0 vs 7·5 years), cardiac involvement (two of 19 vs six of ten), KDSS (zero of 19 vs five of ten), MAS (zero of 19 vs five of ten), and need for adjunctive steroid treatment (three of 19 vs eight of ten; all p<0·01). Interpretation In the past month we found a 30-fold increased incidence of Kawasaki-like disease. Children diagnosed after the SARS-CoV-2 epidemic began showed evidence of immune response to the virus, were older, had a higher rate of cardiac involvement, and features of MAS. The SARS-CoV-2 epidemic was associated with high incidence of a severe form of Kawasaki disease. A similar outbreak of Kawasaki-like disease is expected in countries involved in the SARS-CoV-2 epidemic. Funding None.
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            Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association

            Jane C. Burns, Elfriede Pahl, Tsutomu T. Saji … (2017)
            Kawasaki disease is an acute vasculitis of childhood that leads to coronary artery aneurysms in ≈25% of untreated cases. It has been reported worldwide and is the leading cause of acquired heart disease in children in developed countries.
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              Association between a Novel Human Coronavirus and Kawasaki Disease

              Frank Esper, Eugene D Shapiro, Carla Weibel … (2005)
              Abstract Kawasaki disease is a systemic vasculitis of childhood; its etiology is unknown. We identified evidence of a novel human coronavirus, designated “New Haven coronavirus” (HCoVNH), in respiratory secretions from a 6-month-old infant with classic Kawasaki disease. To further investigate the possible association between HCoV-NH infection and Kawasaki disease, we conducted a case-control study. Specimens of respiratory secretions from 8 (72.7%) of 11 children with Kawasaki disease and from 1 (4.5%) of 22 control subjects (children without Kawasaki disease matched by age and the time the specimens were obtained) tested positive for HCoVNH by reverse-transcriptase polymerase chain reaction (Mantel-Haenszel matched odds ratio, 16.0 [95% confidence interval, 3.4–74.4]; P = .0015). These data suggest that HCoV-NH infection is associated with Kawasaki disease.
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                Author and article information

                Contributors
                Anu Maheshwari:
                ORCID: http://orcid.org/0000-0003-2882-4995
                dranugulati@gmail.com
                Journal
                Journal ID (nlm-ta): Indian J Pediatr
                Journal ID (iso-abbrev): Indian J Pediatr
                Title: Indian Journal of Pediatrics
                Publisher: Springer India (New Delhi )
                ISSN (Print): 0019-5456
                ISSN (Electronic): 0973-7693
                Publication date (Electronic): 22 December 2021
                Pages: 1-6
                Affiliations
                GRID grid.415723.6, Department of Pediatrics, , Lady Hardinge Medical College and associated Kalawati Saran Children Hospital, ; New Delhi, 110001 India
                Author information
                http://orcid.org/0000-0003-2882-4995
                Article
                Publisher ID: 3953
                DOI: 10.1007/s12098-021-03953-9
                PMC ID: 8691965
                PubMed ID: 34935098
                SO-VID: bfe19ec4-9e72-4fa4-ae60-4f377a663fb6
                Copyright © © Dr. K C Chaudhuri Foundation 2021
                License:

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                Date received : 1 March 2021
                Date accepted : 6 August 2021
                Categories
                Subject: Original Article

                ScienceOpen disciplines: Pediatrics
                Keywords: coronary artery aneurysm,infection,kawasaki disease
                Data availability:
                ScienceOpen disciplines: Pediatrics
                Keywords: coronary artery aneurysm, infection, kawasaki disease

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