Previous or coincident infections with suspected Kawasaki disease. Should we change our approach?

Fernández-Cooke, Elisa; Tascón, Ana Barrios; Antón-López, Jordi; Grasa, Carlos; Sánchez-Manubens, Judith; Calvo, Cristina

doi:10.1016/j.anpede.2018.06.011

Cited by 4 publications

(5 citation statements)

References 17 publications

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“…The cause of KD remains unknown; however, it is suggested that an infectious agent might trigger the illness ( 10 ). A small proportion of KD patients present with Kawasaki disease shock syndrome (KDSS) resembling PIMS-TS/MIS-C ( 11 ).…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Clinical Characteristics of SARS-CoV-2 Confirmed and Negative Kawasaki Disease Patients During the Pandemic in Spain

et al. 2021

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Introduction: COVID-19 has a less severe course in children. In April 2020, some children presented with signs of multisystem inflammation with clinical signs overlapping with Kawasaki disease (KD), most of them requiring admission to the pediatric intensive care unit (PICU). This study aimed to describe the prevalence and clinical characteristics of KD SARS-CoV-2 confirmed and negative patients during the pandemic in Spain.Material and Methods: Medical data of KD patients from January 1, 2018 until May 30, 2020 was collected from the KAWA-RACE study group. We compared the KD cases diagnosed during the COVID-19 period (March 1–May 30, 2020) that were either SARS-CoV-2 confirmed (CoV+) or negative (CoV–) to those from the same period during 2018 and 2019 (PreCoV).Results: One hundred and twenty-four cases were collected. There was a significant increase in cases and PICU admissions in 2020 (P-trend = 0.001 and 0.0004, respectively). CoV+ patients were significantly older (7.5 vs. 2.5 yr) and mainly non-Caucasian (64 vs. 29%), had incomplete KD presentation (73 vs. 32%), lower leucocyte (9.5 vs. 15.5 × 109) and platelet count (174 vs. 423 × 109/L), higher inflammatory markers (C-Reactive Protein 18.5vs. 10.9 mg/dl) and terminal segment of the natriuretic atrial peptide (4,766 vs. 505 pg/ml), less aneurysm development (3.8 vs. 11.1%), and more myocardial dysfunction (30.8 vs. 1.6%) than PreCoV patients. Respiratory symptoms were not increased during the COVID-19 period.Conclusion: The KD CoV+ patients mostly meet pediatric inflammatory multisystem syndrome temporally associated with COVID-19/multisystem inflammatory syndrome in children criteria. Whether this is a novel entity or the same disease on different ends of the spectrum is yet to be clarified.

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Section: Introductionmentioning

confidence: 99%

Prevalence and Clinical Characteristics of SARS-CoV-2 Confirmed and Negative Kawasaki Disease Patients During the Pandemic in Spain

et al. 2021

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“…The etiology of KD remains unclear, and no consistent association between any infectious agent and KD has been demonstrated to date, more than half a century since the discovery of KD. While approximately 35% of children with KD have a concurrent infection, 12 the presence of infection does not rule out the diagnosis of KD and ascribing the fever to such an infection or to KD requires clinical judgment.…”

Section: Discussionmentioning

confidence: 99%

Pneumonia in the presentation of Kawasaki disease: The syndrome or a sequence of two diseases?

Khoury

Livnat

Saied

et al. 2022

Clinical Case Reports

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Two cases of Kawasaki disease (KD) presented as persistent lung consolidation associated with Group A Streptococcus and Influenza A co‐infection, which resolved following intravenous immunoglobulin. Thus, pediatricians should consider the diagnosis of KD in the presence of pneumonia that is nonresponsive to antibiotic therapy with prolonged fever and inflammatory reactions.

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“…Chlamydia pneumoniae and Chlamydia psittaci have also been associated with heart infections [37]. It should be noted that Kawasaki syndrome has been reported in association with a variety of infections, among these, C. pneumoniae, though a causal link has never been established [38][39][40][41][42].…”

Section: Discussionmentioning

confidence: 99%

An Intriguing Case of Multisystem Inflammatory Syndrome in an Adult Patient with Remote Infection with COVID-19 and Acute Chlamydia

Chandnani

Charini

Jha

et al. 2021

Case Reports in Infectious Diseases

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Introduction. COVID-19 is associated with a broad range of immune inflammatory phenomena, with different manifestations in adults and children. We describe a case of COVID-19-related multisystem inflammatory syndrome in an adult (MIS-A), similar to that described in children (MIS-C), which may have been set off by an unrelated secondary infection. Case. A 27-year-old male patient presented with acute epididymitis secondary to acute Chlamydia infection that progressed to multisystem inflammatory failure with respiratory failure requiring endotracheal intubation and mechanical ventilation, cardiogenic shock with heart failure, and gastrointestinal and renal dysfunction. He tested negative for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse transcriptase-polymerase chain reaction on a nasopharyngeal swab thrice within 4 days of presentation, but positive for SARS-CoV-2 immunoglobulin G antibody signifying remote infection. The patient was treated with tocilizumab and steroids, along with doxycycline for concurrent Chlamydia infection, resulting in dramatic improvement in all organ function. We suspect that C. trachomatis infection in this instance may have triggered an aberrant immune response that was shaped by prior exposure to SARS-CoV-2. Conclusion. We present a case of an adult patient with acute Chlamydia trachomatis infection occurring in the wake of asymptomatic (or at least unrecognized) COVID-19 resulting in MIS-A. Clinicians should be alert to the possibility of other such unusual reactions occurring in the aftermath of COVID-19. This case also highlights the importance for clinicians who care for adult patients of being familiar with the multisystem inflammatory syndrome of children, as an identical syndrome may occur in adult patients.

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Previous or coincident infections with suspected Kawasaki disease. Should we change our approach?

Cited by 4 publications

References 17 publications

Prevalence and Clinical Characteristics of SARS-CoV-2 Confirmed and Negative Kawasaki Disease Patients During the Pandemic in Spain

Prevalence and Clinical Characteristics of SARS-CoV-2 Confirmed and Negative Kawasaki Disease Patients During the Pandemic in Spain

Pneumonia in the presentation of Kawasaki disease: The syndrome or a sequence of two diseases?

An Intriguing Case of Multisystem Inflammatory Syndrome in an Adult Patient with Remote Infection with COVID-19 and Acute Chlamydia

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