scholarly journals Atypical Kawasaki Disease in an Adolescent with Multivisceral Involvement

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Zohair El Haddar ◽  
Aziza El Ouali ◽  
Ayad Ghanam ◽  
Maria Rkain ◽  
Noufissa Benajiba ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
American Heart Association ◽  
American Heart ◽  
Heart Association ◽  
Clinical Findings ◽  
Cardiac Complications ◽  
Cardiac Damage ◽  
Clinical Criteria ◽  
Atypical Kawasaki Disease ◽  
Delay Of Diagnosis

Kawasaki disease (KD) is a vasculitis mostly seen in children aged less than 5 years. It can involve different organs and tissues. Its diagnosis is based on the clinical criteria of the American Heart Association (AHA). We report a case of a Moroccan adolescent with an atypical presentation of KD initially treated as typhoid fever. Gastrointestinal, renal, and pulmonary signs were the main clinical findings that made the diagnosis of KD challenging and delayed. The consequence was a severe cardiac damage with myocarditis and coronary artery dilation. KD is uncommon in adolescents, and it is important to recognize the atypical forms and the different presentations of KD in order to prevent the delay of diagnosis and treatment, and hence the cardiac complications.

Kawasaki Disease: More Patients Are Being Diagnosed Who Do Not Meet American Heart Association Criteria

PEDIATRICS ◽  
1999 ◽  
Vol 104 (1) ◽  
pp. e10-e10 ◽  
Author(s):  
Mark T. Witt ◽  
L. LuAnn Minich ◽  
John F. Bohnsack ◽  
Paul C. Young
Keyword(s):  
Kawasaki Disease ◽  
American Heart Association ◽  
American Heart ◽  
Heart Association

scholarly journals Immunoglobulin for Kawasaki disease: a 3-year retrospective audit

2019 ◽  
Vol 3 (1) ◽  
pp. e000451
Author(s):  
Beth Pascall ◽  
Arjuna Thakker ◽  
Ying Foo ◽  
Pradip Thakker
Keyword(s):  
Kawasaki Disease ◽  
American Heart Association ◽  
American Heart ◽  
Heart Association ◽  
Tertiary Hospital ◽  
The Past ◽  
Mean Delay ◽  
Retrospective Audit ◽  
Clear Guideline

AimTo evaluate whether intravenous immunoglobulin (IVIG) use in children with suspected Kawasaki disease (KD) was given according to local trust and the newly revised American Heart Association (AHA) guidelines.MethodsIn our tertiary hospital, any child with suspected KD given IVIG, over the past 3 years, was identified. Their electronic notes were then reviewed.ResultsTen patients were identified. Nine patients had a fever lasting 5 days or more. Four patients had either 5/5 or 4/5 of the diagnostic criteria for KD and were diagnosed with complete KD. The remaining six patients were suspected to have incomplete KD. 7/10 patients received IVIG within 10 days of onset of illness. Patients suspected to have incomplete KD experienced a mean delay in administration of IVIG of 5.3 days compared with those with complete KD. In four patients, an alternative diagnosis was established. Three patients had coronary artery abnormalities on first echocardiogram. From these patients, only one had a follow-up echocardiogram recorded in their notes. No patient had more than one follow-up echocardiogram (at both 2 and 6 weeks).ConclusionIdentifying patients with incomplete KD is more difficult than identifying those with complete KD and any delay in giving IVIG could be due to this reason. This audit suggests that increasing awareness of incomplete KD and a clear guideline will aid prompter diagnosis and administration of IVIG. This audit also suggests that all patients with KD should receive more than one follow-up echocardiogram.

What paediatricians need to know about the updated 2017 American Heart Association Kawasaki disease guideline

2019 ◽  
Vol 105 (1) ◽  
pp. 10-12 ◽  
Author(s):  
Linny, K Phuong ◽  
Katherine, YH Chen ◽  
David, P Burgner ◽  
Nigel Curtis
Keyword(s):  
Kawasaki Disease ◽  
American Heart Association ◽  
American Heart ◽  
Heart Association

Improving Preoperative Cardiac Assessment Efficiency by Using the American College of Cardiology/American Heart Association Guidelines: A Quality Improvement Project

2015 ◽  
Vol 8 (2) ◽  
pp. 164-171
Author(s):  
Marcia A. Zuzul ◽  
Paula Tanabe ◽  
Robert Blok ◽  
Kenneth Snyder
Keyword(s):  
Quality Improvement ◽  
American Heart Association ◽  
American Heart ◽  
Guideline Implementation ◽  
Heart Association ◽  
Noncardiac Surgery ◽  
Assessment Process ◽  
Cardiac Complications ◽  
Evidence Based ◽  
Improvement Project

Background: Patients undergoing noncardiac surgery can experience cardiac complications, which are a major cause of morbidity and mortality in the perioperative period. The goal of this quality improvement (QI) project was to standardize the preoperative assessment process and improve patient-centered care by implementing evidence-based practice guidelines for electrocardiogram (ECG) recommendations prior to noncardiac surgery. Methods: Three steps were used to implement the American College of Cardiology/American Heart Association (ACC/AHA) recommendation for ECG to reduce variance in practice and decrease surgical cancellations. A pre- and postdesign was used to evaluate 2 outcomes: decreased surgical cancellations for lack of a current ECG and surgical loss opportunity cost. All data were retrospectively collected for 60 days during the pre- and postperiods. Results: Evidence-based, preoperative ECG recommendations were implemented in the electronic medical record (EMR). Overall, ECG guideline adherence increased from 50% to 66% (χ2 = 2.19, p = .139) postimplementation. Surgical cancellations because of unmet ECG requirements were reduced from 50% to 34% (χ2 = 2.19, p = .139) post-EMR guideline implementation. There was no statistical difference in the cost associated with loss surgical opportunity minutes between the periods (t = 0.79, p = .43, 95% CI [−6.96, 16.24]). Discussion: We successfully implemented an evidence-based guideline recommending specific preoperative ECG requirements within a busy Veterans Administration hospital. This project stimulated ongoing dialogue between the disciplines with positive trends in decreased surgical cancellations.

scholarly journals Hydrocele in a case of atypical Kawasaki disease: case report and review of diagnostic criteria

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Y. R. L. Tan ◽  
C.-T. C. Chow ◽  
I. Ganesan ◽  
H. M. E. Leow
Keyword(s):  
Case Report ◽  
Kawasaki Disease ◽  
Clinical Features ◽  
American Heart Association ◽  
American Heart ◽  
Diagnostic Algorithm ◽  
Heart Association ◽  
Unknown Etiology ◽  
Clinical Presentations ◽  
Disease Case

Abstract Background Kawasaki Disease (KD) is a self-limiting vasculitis of unknown etiology. Although there are well-recognized clinical features associated with classic KD, there have been increasing numbers of atypical clinical presentations with increased dependence on the American Heart Association diagnostic algorithm for incomplete KD. Case presentation We report on a child who was initially treated for Escherichia coli left pyelonephritis and Influenza A and Rhinovirus / Enterovirus upper respiratory tract infection. The child developed an acute hydrocele and a maculopapular rash during the illness course, which prompted further evaluation for concomitant atypical KD, although there were no other physical signs suggestive of classic KD at the time. Subsequent diagnosis of atypical KD was made with confirmation on echocardiography, with timely administration of intravenous immunoglobulin. Conclusions Although there are well recognized clinical features associated with classic Kawasaki Disease, there have been increasing numbers of atypical clinical presentations with increased dependence on the American Heart Association diagnostic algorithm for incomplete Kawasaki Disease. This case report highlights the importance of considering a diagnosis of KD in a child with prolonged fever and unexplainable symptoms suggestive of inflammation, in this case, the rare presentation of an acute hydrocele. We recommend that for any child with prolonged unexplained fever, Kawasaki Disease should be considered. Trial registration Not applicable.

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