Clinical Significance of the Bacille Calmette-Guérin Site Reaction in Kawasaki Disease Patients Aged Less than 18 Months

Park, Sung Hyeon; Yu, Jeong Jin; You, Jihye; Kim, Mi Jin; Shin, Eun Jung; Jun, Hyun Ok; Baek, Jae Suk; Kim, Young-Hwue; Ko, Jae-Kon

doi:10.14776/piv.2018.25.e11

Cited by 5 publications

(3 citation statements)

References 14 publications

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“…This is in contrast to a previous study, 8 which showed that an infant aged < 1 year was associated with delayed diagnosis. This could be due to a high number of supportive signs (e.g., BCG scar and perianal peeling) in younger rather than older children, which help clinicians make a timely diagnosis 16 . Another factor could be the high number of atypical presentations in older children in this cohort.…”

Section: Discussionmentioning

confidence: 96%

“…This could be due to a high number of supportive signs (e.g., BCG scar and perianal peeling) in younger rather than older children, which help clinicians make a timely diagnosis. 16 Another factor could be the high number of atypical presentations in older children in this cohort. However, as with previous studies, 6,8 this study showed that incomplete KD was associated with delayed diagnosis.…”

Section: In 2011 the Reduction Of Delayed Diagnosismentioning

confidence: 96%

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Delayed diagnosis of Kawasaki disease in Malaysia: Who is at risk and what is the outcome

Bah

Alias

Sapian

et al. 2022

Pediatrics International

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Background Data on the delayed diagnosis of (KD) is limited. This study aimed to determine the prevalence and trend of delayed diagnosis over time and identify the associated risk factors in Malaysia. Methods This retrospective, observational, population‐based study involved all children with KD registered in Johor Kawasaki Clinical Registry over 10 years (January 2010 and December 2019). The prevalence of delayed diagnosis and its trend over time was calculated. Multivariable binary logistic regression was used to identify the independent risk factors for delayed diagnosis. Results There were 556 cases of KD, with 28% having incomplete criteria, 11% atypical presentation, while 10% developed a coronary aneurysm. The overall prevalence of delayed diagnosis was 9.9% (95% confidence interval (CI): 7.6–12.7%). There was a statistically significant decrease in delayed diagnosis over time (P = 0.008), with the latest rate of 4.6%. The majority of delayed diagnoses were due to failure to diagnose the disease during the initial consultation. Independent risk factors for delayed diagnosis were children older than 1 year, diagnosis before 2015, atypical presentation, and incomplete KD, with adjusted odds ratios (ORs) of 2.7, 2.3, 4.3, and 3.6, respectively. Compared to early diagnosis of KD, delayed diagnosis was significantly associated with coronary aneurysms (27.3% vs. 8.2%, P < 0.001, OR 4.2, [95% CI: 2.1–8.3]). Conclusions One‐tenth of cases of KD were diagnosed late, but it has improved over time. Children > 1 year, presenting with atypical presentation, and incomplete criteria are associated with late diagnosis.

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Section: Discussionmentioning

confidence: 96%

Section: In 2011 the Reduction Of Delayed Diagnosismentioning

confidence: 96%

Delayed diagnosis of Kawasaki disease in Malaysia: Who is at risk and what is the outcome

Bah

Alias

Sapian

et al. 2022

Pediatrics International

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“…Looking at the age distribution of Kawasaki disease with BCGitis, the incidence peaked at six months of age and then decreased with age [ 5 , 10 , 11 ]. In Korea, more than 70% of Kawasaki disease cases with BCGitis are <18 months of age, and the peak incidence is observed at 6–8 months and then decreases [ 15 ]. In the present study, 34% of all patients had BCGitis, and the median age was 10 (IQR 6–19) months.…”

Section: Discussionmentioning

confidence: 99%

Bacille Calmette-Guérin Site Reactivation of Kawasaki Disease in Infants under 3 Months of Age: Relation with Diagnosis and Prognosis

2022

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Diagnosis of Kawasaki disease in infants under 3 months of age is challenging. This study aimed to confirm the diagnostic efficacy of BCGitis in patients with Kawasaki disease aged <3 months. Overall, 473 children were enrolled; they were grouped by age into group 1 (≤3 months, n = 19) and group 2 (>3 months, n = 454). Data, including clinical features and laboratory results, were analyzed and compared between the groups. In group 1, 89% of patients showed Bacille Calmette-Guérin site reactivation. In group 1, total duration of fever and fever duration before initial treatment were significantly shorter than in group 2 (p = 0.001). The incidences of conjunctival injection, changes in extremities (erythema and edema), and cervical lymphadenopathy were significantly lower (p = 0.006, p = 0.040, and p < 0.001, respectively), and desquamation was higher in group 1 (p = 0.004). The incidences of incomplete Kawasaki disease, coronary artery complications, and resistance to intravenous immunoglobulin did not differ between the groups. Kawasaki disease should be suspected in infants aged <3 months with unexplained fever and BCGitis, even if the principal clinical symptoms are not fully presented. BCGitis in infantile Kawasaki disease is a useful sign and can help in the diagnosis of Kawasaki disease.

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Heart Disease and Stroke Statistics—2020 Update: A Report From the American Heart Association

Virani¹,

Alonso²,

Benjamin³

et al. 2020

Circulation

6,788

4,416

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Background: The American Heart Association, in conjunction with the National Institutes of Health, annually reports on the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). Methods: The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2020 Statistical Update is the product of a full year’s worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year’s edition includes data on the monitoring and benefits of cardiovascular health in the population, metrics to assess and monitor healthy diets, an enhanced focus on social determinants of health, a focus on the global burden of cardiovascular disease, and further evidence-based approaches to changing behaviors, implementation strategies, and implications of the American Heart Association’s 2020 Impact Goals. Results: Each of the 26 chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. Conclusions: The Statistical Update represents a critical resource for the lay public, policy makers, media professionals, clinicians, healthcare administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

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Clinical Significance of the Bacille Calmette-Guérin Site Reaction in Kawasaki Disease Patients Aged Less than 18 Months

Cited by 5 publications

References 14 publications

Delayed diagnosis of Kawasaki disease in Malaysia: Who is at risk and what is the outcome

Delayed diagnosis of Kawasaki disease in Malaysia: Who is at risk and what is the outcome

Bacille Calmette-Guérin Site Reactivation of Kawasaki Disease in Infants under 3 Months of Age: Relation with Diagnosis and Prognosis

Heart Disease and Stroke Statistics—2020 Update: A Report From the American Heart Association

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