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Fever, bulbar conjunctival injection most common symptoms of Kawasaki disease
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Fever and bulbar conjunctival injection were the most common symptoms of Kawasaki disease, according to the results of a recent study published in The Pediatric Infectious Disease Journal.
“We found that [Kawasaki disease] occurs more frequently in children younger than 5 years, in boys, and during the summer months,” researchers wrote. “Redness at a [bacille Calmette-Guérin] inoculation site was more frequent in young infants, while cervical lymphadenopathy was more frequent in school-aged children.”
The retrospective study included 1,370 children with acute Kawasaki disease. Clinical features of each age group and risk factors for coronary artery lesions caused by Kawasaki disease were analyzed.
Researchers found that 30.4% of Kawasaki disease cases occurred in the summer (May to July), followed by 25.5% in the spring (February to April), 23.1% in fall (August to October) and 20.9% in winter (November to January).
Besides fever, the most common symptoms were bulbar conjunctival injection (95.6%); reddening and cracking of lips (89.2%); rash (82.3%); edema in the extremities (77.4%); strawberry tongue (59.4%); desquamation of the fingertips (51.6%); perianal desquamation (39.5%); cervical lymphadenopathy (34.3%); and redness at a bacille Calmette-Guérin inoculation site (3.5%).
Two-dimensional echocardiography tests were performed in 98.4% of participants. Of those, 36.1% developed coronary artery lesions, 27.5% of those had coronary artery dilation only, 7.6% had medium coronary artery aneurysms, and 0.96% had giant coronary artery aneurysms.
“Patients with multiple risk factors for coronary artery lesions should be closely monitored and treated promptly with [intravenous immunoglobulin], particularly febrile infants younger than 6 months,” researchers wrote. “If fever persists, the development of coronary artery aneurysms is more likely. Thus, more aggressive therapy should be considered to block the inflammatory response and prevent additional coronary artery damage.”
Disclosure: The researchers report no relevant financial disclosures.
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