• Pediatric Infection and Vaccine
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• v.7 no.1
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• pp.152-158
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• 2000

Purpose : Kawasaki disease is an acute illness of unknown cause that affects infants and children. Sometimes, cervical lymphadenitis that seems to be caused by bacterial or viral agents at admission would be changed to Kawasaki disease within several days of hospitalization. Lymphadenopathy is one of major presenting manifestation of both cervical lymphadenitis and Kawasaki disease. We compared Kawasaki disease with cervical lymphadenopathy as the initial manifestation with cervical lymphadenitis without other typical manifestations of Kawasaki disease. Methods : We describe and compare the clinical characteristics of 15 patients with Kawasaki disease which were misdiagnosed as cervical lymphadenitis and 125 patients with cervical lymphadenitis, retrospectively. Results : The clinical characteristics of Kawasaki disease with cervical lymphadenopathy as an initial presenting manifestation were older in age and had more frequent abnormalities in markers of systemic inflammation than kawasaki disease without cervical lymphadenopathy. They would have greater abnormalities in markers of inflammation than cervical lymphadenitis alone. They had higher mean WBC, cESR, CRP which were compared with the patients with cervical lymphadenitis. Usually, patients with cervical lymphadenitis responded to antibiotics promptly, but they did not tend to be responded to antibiotics within 48~72hrs. Conclusion : Patients with Kawasaki disease may initially present with findings that strongly suggest bacterial lymphadenitis with or without other manifestations of Kawasaki disease. If they did not response initial antibiotics administration, they should be closed observed for the possible development of the another signs of Kawasaki disease. Earlier diagnosis of Kawasaki disease can avoid the need for unnecessary procedures and antibiotics and lead to more proper therapy directed at Kawasaki disease.

• Journal of Yeungnam Medical Science
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• v.17 no.2
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• pp.99-107
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• 2000

Kawasaki disease, an acute febrile illness which primarily affects in children under the age of six, was first described by Tomisaku Kawasaki in 1967. It has been reported that Kawasaki disease is probable driven by abnormalities of the immune system after an infectious insult, but this has not been confirmed. It mainly affects small and medium-sized arteries, particularly the coronary arteries. Deaths may occur at any time with cardiovascular complications. The early recognition and treatment with follow-up evaluation for the coronary arterial lesion is very important in a case of Kawasaki disease.

• Pediatric Infection and Vaccine
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• v.3 no.2
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• pp.139-144
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• 1996

Purpose : Coxiella burnetii is a well-known causative agent of granuolmatous inflammation and an inducer of morphological change and transformation of human B lymphocyte in vitro. Coxiella burnetii manifests with several clinical symptoms depending upon the organs that are involved. We therefore undertook to clarify the association of Kawasaki disease and Coxiella burnetii. Subjects and Methods : The patient's sera were tested for antibodies specific for Coxiella burnetii, using indirect fluorescent antibody technique(IFA). We compared Coxiella burnetii infection with 3 groups of patients, group 1 (Kawasaki disease), group 2 (other febrile disease) and group 3 (control group). Results : 1) In children with Kawasaki disease (group 1), 93% of the patient tested positive for Coxiella burnetii. 2) In group 2 children, 20% of the patient tested positive for Coxiella burnetii. 3) In group 3 children, 10% of the patient tested positive for Coxiella burnetii 4) There were significant higher positive rate for Coxiella burnetii in Kawasaki disease than group 2 and group 3 (p<0.05). Conclusions : We concluded that our cases of Kawasaki disease were associated with Coxiella burnetii infection. Further studies will be needed to understand the precise role of Coxiella infection in Kawasaki disease.

• Clinical and Experimental Pediatrics
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• v.51 no.5
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• pp.462-467
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• 2008

Kawasaki disease is a systemic vasculitis of unknown etiology, usually occurring in infants and young children. Although the etiology of Kawasaki disease remains uncertain, its serious complicationssuch as giant aneurysm formation, coronary arterial stenotic lesions, and thrombotic occlusionhave been proven to cause myocardial ischemia or infarction in patients with Kawasaki disease. To prevent and treat these complications, several modes of therapyincluding long-term anticoagulation, interventional catheterization, and surgical treatmenthave been gradually developed. In this article, we review the cardiovascular complications following Kawasaki disease and the management thereof, which includes thrombolytic therapy, catheter intervention, and coronary artery bypass graft.

• Clinical and Experimental Pediatrics
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• v.55 no.3
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• pp.83-87
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• 2012

Several authors suggested that the clinical characteristics of incomplete presentation of Kawasaki disease are similar to those of complete presentation and that the 2 forms of presentation are not separate entities. Based on this suggestion, a diagnosis of incomplete Kawasaki disease in analogy to the findings of complete presentation is reasonable. Currently, the diagnosis of incomplete Kawasaki disease might be made in cases with fewer classical diagnostic criteria and with several compatible clinical, laboratory or echocardiographic findings on the exclusion of other febrile illness. Definition of incomplete presentation in which coronary artery abnormalities are included as a necessary condition, is restrictive and specific. The validity of the diagnostic criteria of incomplete presentation by the American Heart Association should be thoroughly tested in the immediate future.

• Journal of Chest Surgery
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• v.32 no.9
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• pp.831-834
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• 1999

The Kawasaki disease has been reported worldwide since the first description in 1967 in Japan. Approximately 20% of the children with untreated Kawasaki disease are believed to develop coronary artery aneurysm of which 2-3% progress to coronary artery stenosis. The Kawasaki disease rarely affects adults and accordingly, there have been only a few cases reported in literatures. The present case describes a successful surgical treatment of a 43-year-old female patient with coronary artery aneurysm and stenosis, which resulted from an episode of the Kawasaki disease that occurred 20 years earlier. The patient was well at 5 months followup.

• IMMUNE NETWORK
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• v.2 no.4
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• pp.202-207
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• 2002

Background: Kawasaki disease is an acute febrile illness with systemic vasculitis which primarily affects children, We examined the production of leptin in plasma and gene expressions of CXC chemokines in peripheral blood mononuclear cells from patients with Kawasaki disease. Methods: Consecutive 39 samples from 13 patients according to the different clinical stages (acute, subacute, convalescent) of Kawasaki disease were collected. The plasma leptin levels according to clinical stages of Kawasaki disease were examined by ELISA and the expression of IP-10, Mig and IL-8 mRNAs in 39 samples (13 samples of each stage) from 13 cases were examined by RT-PCR. Results: There were not significant changes of plasma leptin levels according to the clinical stages of Kawasaki disease. The mean values of plasma leptin concentrations during each of the stages (n=13, p>0.05, pg/ml) were $335.8{\pm}549.0$ in acute, $358{\pm}347.6$ in subacute, and $443.6{\pm}645.9$ in convalescent stage. The mRNAs of IP-10, Mig, and IL-8 were expressed in 13/13 (100%), 2/13 (15%), 9/13 (69%) during acute stage, 13/13 (100%), 6/13 (46%), 13/13 (100%) during subacute stage, and 13/13 (100%), 4/13 (31%), 10/13 (77%) during the convalescent stage, respectively. In three patients, the production of leptin and expression of IP-10 mRNA were dramatically decreased according to the process of the clinical stages. In five patients with prominent cervical lymphadenopathy, the expression of IL-8 mRNA during the subacute stage was more elevated than the acute and convalescent stages. Conclusion: This data suggests that the production of leptin and the gene expressions of IP-10, Mig and IL-8 seem to have no significant correlation to the clinical stages of Kawasaki disease. However, expression patterns of IP-10, Mig and IL-8 mRNA may be related to the specific clinical manifestations, and the expression of IP-10 may also be correlated to leptin levels with pericardial involvement.

• Pediatric Infection and Vaccine
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• v.21 no.3
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• pp.214-218
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• 2014

Kawasaki disease is generally diagnosed base on its clinical features. Sometimes unusual or atypical presentations make the diagnosis of Kawasaki disease difficult. We experienced an unusual case of Kawasaki disease presented with unilateral parotitis in a 23-month old girl. Despite of intravenous antibiotics treatment, fever and unilateral parotid swelling persisted. Skin rashes, conjunctival injections, and coronary abnormalities showed up on the 8th day of fever. After the intravenous immunoglobulin and salicylates treatment, all symptoms disappeared. Although unilateral parotitis is very unusual presentation of Kawasaki disease, in case of no response to antibiotics, Kawasaki disease should be included in the differential diagnosis.

• Clinical and Experimental Pediatrics
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• v.58 no.11
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• pp.434-439
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• 2015

Purpose: Kawasaki disease involves acute febrile systemic vasculitis that can cause a variety of symptoms by affecting various organs. Here, we aimed to evaluate the prevalence, causes, and prognosis of sensorineural hearing loss (SNHL) occurring in children with Kawasaki disease. Methods: Patients who were diagnosed with Kawasaki disease and received inpatient treatment in the Pediatrics Department at one of three university hospitals in Daegu city from February 2012 to September 2012 were enrolled in the study. The clinical features, hematological results, echocardiography results, audiometry results, and aspirin and salicylic acid serum levels of the patients were evaluated. Results: Of the 59 children enrolled in the study, three showed mild bilateral SNHL on audiometry tests conducted after 48 hours of defervescence; these patients demonstrated normal patterns of recovery on follow-up tests 8 weeks later. Aspirin serum levels were significantly higher in the SNHL group after 48 hours of afebrile condition with high dose aspirin intake (P=0.034). However, no significant differences were found in other laboratory tests or for fever duration (P>0.05). Upon echocardiography, coronary artery abnormality was observed in 9 cases, but none of these patients showed hearing loss. Conclusion: The results indicate that SNHL in children with Kawasaki disease might occur during treatment of the acute phase; this SNHL usually involves mild bilateral hearing loss and recovers naturally. However, this study suggests that determination of the causes and clinical implications of hearing loss in Kawasaki disease requires long-term follow-up studies with more cases.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.4 no.2
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• pp.233-237
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• 2001

Kawasaki Disease, an acute systemic vasculitis of unknown etiology, is the leading cause of acquired heart disease in children in many parts of the world. It predominantly affects children under 5 years of age and has many clinical symptoms. We experienced a case of gas forming enterocolitis associated with Kawasaki Disease. Aeromonas hydrophilia was isolated from her stool culture. So, we report the case with a brief review of its literature.