Kawasaki disease complicated by peripheral gangrene and a ventricular septal defect: An unusual association

Abstract

Kawasaki disease is an acute febrile illness associated with the vasculitis of small and medium size arteries. Peripheral gangrene is very rare but a known complication of Kawasaki disease mostly reported in the infantile age group. Early therapy is advocated for prevention of serious complications. We report a 10-month-old girl with Kawasaki disease and a small ventricular septal defect who developed peripheral gangrene despite initiation of early therapy.

Kawasaki disease for the paediatric dermatologist: skin manifestations and new insights into the pathophysiology

“…Distal ischaemia complicates occasionally KD, and can result in peripheral gangrene and amputation of toes and/or fingers 20–22 . This complication is more often reported in very young children (mean age 3 months) with incomplete KD 22 …”

Internationally educated dermatologists in the active Medicare workforce

“…Two of them even died as a result of cardiac complications. [1][2][3][4][5] It is worth underlining that all of the cases reported were under 15 months of age, while our patient was 3 years old. This, alongside the early onset of treatment, may have been a key factor in the favorable clinical outcome of our patient.The pathogenesis of peripheral gangrene in KD remains unclear.…”

“…Eventually, severe cardiovascular complications may occur, such as arterial aneurysms and myocardial infarction. 2 Peripheral gangrene is an uncommon but severe complication. To date, there are only 20 cases reported in the literature, 16 of which required amputation of phalanges.…”

“…It is a condition of unknown etiology, although it is widely believed that it is caused by superantigens. 2,3 The symptoms include high fever, bilateral conjunctivitis, changes in the lips and mouth, swelling of hands and feet with scaling of the fingertips, polymorph exanthema, and cervical lymphadenopathy. Eventually, severe cardiovascular complications may occur, such as arterial aneurysms and myocardial infarction.…”

“…1 One proposed solution to increase diversity is to remove barriers for international medical graduates (IMGs) in the residency application process. 2 In this crosssectional study, we sought to characterize dermatologists actively seeing Medicare patients who graduated from medical schools outside of the United States.…”