Title: Atypical Infantile Kawasaki Disease with Rare Presentation of Purulent Conjuctivitis: Case Report
Authors: Nishant Acharya, Priyanka Sharma, Parvinder Singh
DOI: https://dx.doi.org/10.18535/jmscr/v8i6.89
Abstract
Kawasaki disease (KD) is a medium vessel vasculitis which presents as an acute febrile illness affecting young children with 80% affecting less than 5 years and with slight male preponderance. KD remains purely a clinical diagnosis rests on the recognition of a typical temporal sequence of a constellation of clinical features. The main concern about the KD is development of coronary artery abnormalities (CAA) in 15-25% of affected individuals. The diagnosis of infantile KD can be particularly difficult due to obscure clinical manifestations and presentation is usually incomplete or atypical. Adenovirus poses the greatest diagnostic dilemma which presents with many of the features consistent with the atypical KD. We are illustrating a case of infant with features temporally correlating with Kawasaki disease but some atypical features like purulent conjunctivitis.
Keywords: Kawasaki disease, Atypical, Purulent conjunctivitis, Mucocutaneus lymph node syndrome
References
- Kawasaki T. Acute febrile mucocutaneous syndrome with lymphoid involvement with specific desquamation of the fingers and toes in children [Japanese]. Arerugi 1967; 16: 178 222.
- Kawasaki T. General review and problems in Kawasaki disease. Jpn Heart J 1995; 36: 1-12.
- Sundel RP, Petty RE. Kawasaki disease. In: Cassidy JT, Petty RE, Laxer RM, Lindsley CB. Textbook of Pediatric Rheumatology. 5th Ed. Philadelphia: Elsevier Saunders; 2005. p. 521-538.
- Committee on Rheumatic fever, Endocarditis, and Kawasaki Disease of the American Heart Association’s Council on Cardiovascular Disease in the Young. Diagnostic guidelines for Kawasaki disease. Am J Dis Child 1990; 144: 1218-1219.
- Neuwirth CA, Singh H. Intercostal artery aneurysm in a child with Kawasaki disease and known coronary artery aneurysms. J Vasc Interv Radiol 2010; 21: 9523.
- JCS Joint Working Group. Guidelines for diagnosis and management of cardiovascular sequelae in Kawasaki disease (JCS 2008): digest version. Circ J 2010; 74: 19892020.
- Kim SH, Kim KH, Kim DS. Clinical characteristics of Kawasaki disease according to age at diagnosis. Indian Pediatr 2009; 46: 58590.
- Burns JC, Wiggins JW Jr, Toews WH, Newburger JW, Leung DY, Wilson H, et al. Clinical spectrum of Kawasaki disease in infants younger than 6 months of age. J Pediatr 1986; 109: 75963.
- Liu HC, Lo CW, Hwang B, Lee PC. Clinical manifestations vary with different age spectrums in infants with Kawasaki disease. Scientific World Journal 2012; 2012: 210382.
- Shulman ST, McAuley JB, Pachman LM, Miller ML, Ruschhaupt DG. Risk of coronary abnormalities due to Kawasaki disease in urban area with small Asian population. Am J Dis Child. 1987; 141: 420–5.
- Sundel RP, Petty RE. Kawasaki disease. In: Cassidy JT, Petty RE, Laxer RM, Lindsley CB, editors. Textbook of pediatric rheumatology. 6th ed. Philadelphia: Elsevier Saunders; 2011. p. 505–20.
- Stephen R barone et al. The differentiation of classical Kawasaki disease, atypical Kawasaki disease, and acute Adenoviral infection. Arch pediatr adoles med 2000; 154: 453-56.