Kawasaki Disease: Early Presentation to the Otolaryngologist

Kawasaki disease is an acute febrile illness of unknown etiology that occurs primarily in childhood. Early diagnosis and treatment can reduce the risk of cardiac complications of Kawasaki disease, which carries a 1% to 2% mortality for cardiovascular events. Clinical features include: (1) fever (2) conjunctival injection (3) oral cavity changes (4) changes in the peripheral extremities (5) erythematous rash and (6) cervical adenopathy without suppuration. We describe three cases in detail and survey a series of 42 patients at our institution. Otolaryngologic manifestations were found to occur in the early stages of Kawasaki disease. The otolaryngologist may see these patients early in the disease and should be alert to the signs and symptoms for appropriate diagnosis and treatment. Characteristics of Kawasaki disease, difficulties in diagnosis during the initial febrile stage, and the importance of early diagnosis by the otolaryngologist is stressed.

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Lymphadenitis as the Dominant Manifestation of Kawasaki Disease

PEDIATRICS ◽

10.1542/peds.93.3.525 ◽

1994 ◽

Vol 93 (3) ◽

pp. 525-528

Author(s):

Julie Kim Stamos ◽

Kathleen Corydon ◽

James Donaldson ◽

Stanford T. Shulman

Keyword(s):

Kawasaki Disease ◽

Cervical Lymphadenopathy ◽

Febrile Illness ◽

The United States ◽

Acute Febrile Illness ◽

Conjunctival Injection ◽

Coronary Abnormalities ◽

Acquired Heart Disease ◽

Mucosal Changes ◽

Infants And Young Children

Kawasaki disease (KD) is an acute febrile illness primarily affecting infants and young children. Its importance relates to the fact that 20% to 25% of untreated patients develop coronary abnormalities that can lead to myocardial infarction or even to death.1 KD is a leading cause of acquired heart disease in children in many regions, including the United States.2 Because there are no specific diagnostic tests for KD, the diagnosis is established by the presence of fever and four of five criteria without other explanation for the illness: (1) nonexudative conjunctival injection; (2) oral mucosal changes; (3) changes of the peripheral extremities; (4) rash, primarily truncal; and (5) cervical lymphadenopathy.

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The “Intermediate” CD14 + CD16 + monocyte subpopulation plays a role in IVIG responsiveness of children with Kawasaki disease

Pediatric Rheumatology ◽

10.1186/s12969-021-00573-7 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Yi Seul Kim ◽

Hyun Jin Yang ◽

Seung-Jung Kee ◽

Insu Choi ◽

Kisoo Ha ◽

...

Keyword(s):

Kawasaki Disease ◽

Laboratory Tests ◽

Febrile Illness ◽

Cardiac Complications ◽

Study Cohort ◽

Ivig Infusion ◽

Functional Studies ◽

Ivig Resistance ◽

Resistant Group ◽

Intermediate Monocytes

Abstract Background Kawasaki disease (KD) is an acute, self-limited febrile illness of unknown cause. Intravenous immunoglobulin (IVIG)-resistance are related to greater risk for permanent cardiac complications. We aimed to determine the correlation between monocytes and the phenotype of KD in relation to IVIG responsiveness in children. Materials and methods The study cohort included 62 patients who were diagnosed with KD, 20 non febrile healthy controls (NFC), and 15 other febrile controls (OFC). In all enrolled patients, blood was taken at least 4 times and laboratory tests were performed. In addition, subtypes of monocytes were characterized via flow cytometry. Results The numbers of intermediate monocytes were significantly lower in IVIG-resistant group compared to IVIG-responsive group before IVIG infusion (p < 0.0001). After infusion, intermediate monocytes decreased in the responsive group, while a trend of increase was observed in the resistant group. Only intermediate monocytes were significant in logistic regression with adjusted OR of 0.001 and p value of 0.03. Conclusions CD14 + CD16 + intermediate monocyte may play an important role in IVIG responsiveness among KD children. Low starting levels of intermediate monocytes, followed by a dramatic increase post-IVIG infusion during acute phase of KD are associated with IVIG-resistance. Functional studies on intermediate monocyte may help to reveal the pathophysiology.

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Laryngeal cancer

InnovAiT Education and inspiration for general practice ◽

10.1177/17557380211010564 ◽

2021 ◽

pp. 175573802110105

Author(s):

Kelvin Miu

Keyword(s):

Head And Neck Cancer ◽

Early Diagnosis ◽

Head And Neck ◽

Patient Outcomes ◽

Laryngeal Cancer ◽

Neck Cancer ◽

Early Recognition ◽

Signs And Symptoms ◽

Diagnosis And Treatment

Laryngeal cancer is a common head and neck cancer and typically presents with voice hoarseness in patients older than 60 years. Early recognition of signs and symptoms of laryngeal cancer can lead to early diagnosis and treatment, therefore improving patient outcomes. This article aims to provide an overview of the anatomy of the larynx, presentation and management of laryngeal cancer, and common follow-up problems.

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Pitfalls in acute febrile illness diagnosis: Interobserver agreement of signs and symptoms during a dengue outbreak

Journal of Clinical Nursing ◽

10.1111/jocn.15229 ◽

2020 ◽

Vol 29 (9-10) ◽

pp. 1590-1598

Author(s):

Sibelle Nogueira Buonora ◽

Sonia Regina Lambert Passos ◽

Regina Paiva Daumas ◽

Matheus Garcia Lago Machado ◽

Guilherme Miguéis Berardinelli ◽

...

Keyword(s):

Interobserver Agreement ◽

Febrile Illness ◽

Signs And Symptoms ◽

Acute Febrile Illness ◽

Dengue Outbreak

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Meningococcal Meningitis in Patients with Falciparum Malaria

Tropical Doctor ◽

10.1177/004947559602600405 ◽

1996 ◽

Vol 26 (4) ◽

pp. 157-159 ◽

Cited By ~ 2

Author(s):

Dawit Wolday ◽

Tsehaye Kibreab ◽

Daraus Bukenya ◽

Richard Hodes

Keyword(s):

Early Diagnosis ◽

Falciparum Malaria ◽

Signs And Symptoms ◽

Refugee Camp ◽

Meningococcal Meningitis ◽

Morbidity And Mortality ◽

Diagnosis And Treatment ◽

Field Hospital ◽

Meningeal Irritation

Between October 1994 and January 1995 a field hospital saw nine cases of falciparum malaria associated with meningococcal meningitis among Rwandan patients residing in Kibumba refugee camp in Goma, Zaire. All except one presented with signs and symptoms suggestive of meningeal irritation; all but one responded to intravenous quinine and chloramphenicol or ampicillin. Two had recrudescence of malaria and responded to treatment with pyrimethamine-sulphadoxine (Fansidar). There were no sequelae seen. Meningococcal meningitis is uncommon but frequently fatal if it occurs in patients with falciparum malaria. Early diagnosis and treatment are urgent to decrease morbidity and mortality.

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Pathological observations concerning the cardiovascular lesions in Kawasaki disease

Cardiology in the Young ◽

10.1017/s1047951100000408 ◽

1991 ◽

Vol 1 (3) ◽

pp. 212-220 ◽

Cited By ~ 41

Author(s):

Shiro Naoe ◽

Kazutoshi Shibuya ◽

Kei Takahashi ◽

Megumi Wakayama ◽

Hirotake Masuda ◽

...

Keyword(s):

Lymph Node ◽

Kawasaki Disease ◽

Lymph Nodes ◽

Febrile Illness ◽

Clinical Entity ◽

Acute Febrile Illness ◽

Mucocutaneous Lymph Node Syndrome ◽

Cervical Lymph Nodes ◽

In Infants And Children ◽

Lymph Node Syndrome

In about 1967, a new clinical entity in infants and children was described in Japan. It was an acute febrile illness associated with engorgement of the conjunctivas, labial erythema, and swelling of the deep cervical lymph nodes without suppuration. This disease is usually called the acute febrile mucocutaneous lymph node syndrome or, more simply, Kawasaki disease.

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INCIDÊNCIA HIPOTIREOIDISMO CONGÊNITO EM CRIANÇAS NASCIDAS NOS HOSPITAIS PÚBLICOS DO OESTE PAULISTA

Colloquium Vitae ◽

10.5747/cv.2020.v13.n1.v316 ◽

2021 ◽

Vol 13 (1) ◽

pp. 01-06

Author(s):

Franciele Cardoso Leite ◽

Patricia Martins Luizari Escoboza

Keyword(s):

Early Diagnosis ◽

Congenital Hypothyroidism ◽

Signs And Symptoms ◽

Cross Sectional Study ◽

Thyroid Stimulating Hormone ◽

Public Hospitals ◽

Diagnosis And Treatment ◽

Screening Tests ◽

Cross Sectional ◽

Prick Test

Congenital hypothyroidism is a cause of mental retardation and has nonspecific signs and symptoms. Early diagnosis and treatment are essential for the normal development of children affected by this disorder. The objective of this study was to evaluate theincidence of changes in the screening tests of public hospitals in Presidente Prudente, the average age of the newborn at the time of collection of tests and confirmation of the diagnosis. A retrospective cross-sectional study was carried out to assess the data of newborns who underwent the “heel prick test” by the unified health system in 2017. Of the 3,351 evaluated, 48 had elevated levels of Thyroid Stimulating Hormone(TSH), 13 had the diagnosis confirmed congenital hypothyroidism. It was 61.54% the children that returned between days 16 and 30 to confirm the result and 23.07% that returned after 61 days. Early diagnosis and treatment is essential, as they enable mitigating actions for the serious cognitive and behavioral disorders of affected patients.

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Redefining typhoid diagnosis: what would an improved test need to look like?

10.1101/19001958 ◽

2019 ◽

Author(s):

Richard Mather ◽

Heidi Hopkins ◽

Christopher M. Parry ◽

Sabine Dittrich

Keyword(s):

Typhoid Fever ◽

Diagnostic Test ◽

Clinical Medicine ◽

Point Of Care ◽

Treatment Algorithm ◽

Febrile Illness ◽

Diagnosis And Treatment ◽

Acute Febrile Illness ◽

Next Generation ◽

Antibiotic Overuse

IntroductionTyphoid fever is one of the most common bacterial causes of acute febrile illness in the developing world, with an estimated 10.9 million new cases and 116.8 thousand deaths in 2017. Typhoid point-of-care (POC) diagnostic tests are widely used but have poor sensitivity and specificity, resulting in antibiotic overuse that has led to the emergence and spread of multidrug resistant strains. With recent advances in typhoid surveillance and detection, this is the ideal time to produce a target product profile (TPP) that guides product development and ensure that a next-generation test meets the needs of users in the resource-limited settings where typhoid is endemic.MethodsA structured literature review was conducted to develop a draft TPP for a next-generation typhoid diagnostic test with minimal and optimal desired characteristics for 36 test parameters. The TPP was refined using feedback collected from a Delphi survey of key stakeholders in clinical medicine, microbiology, diagnostics and public and global health.ResultsA next-generation typhoid diagnostic test should improve patient management through the diagnosis and treatment of infection with acute Salmonella enterica serovars Typhi or Paratyphi with a sensitivity ≥90% and specificity ≥95%. The test would ideally be used at the lowest level of the healthcare system in settings without a reliable power or water supply and provide results in less than 15 minutes at a cost of <$1.00 USD.ConclusionThis report outlines the first comprehensive TPP for typhoid fever and is intended to guide the development of a next-generation typhoid diagnostic test. An accurate POC test will reduce the morbidity and mortality of typhoid fever through rapid diagnosis and treatment and will have the greatest impact in reducing antimicrobial resistance if it is combined with diagnostics for other causes of acute febrile illness in a treatment algorithm.

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Atypical Kawasaki Disease with Aortic Aneurysm

PEDIATRICS ◽

10.1542/peds.68.6.885 ◽

1981 ◽

Vol 68 (6) ◽

pp. 885-888 ◽

Cited By ~ 1

Author(s):

Charles E. Canter ◽

Richard J. Bower ◽

Arnold W. Strauss

Keyword(s):

Myocardial Infarction ◽

Kawasaki Disease ◽

Aortic Aneurysm ◽

Unusual Case ◽

Febrile Illness ◽

Signs And Symptoms ◽

The United States ◽

Abdominal Aortic ◽

Atypical Kawasaki Disease ◽

Arterial Aneurysms

Kawasaki disease (mucocutaneous lymph node syndrome), initially described in Japan, is now being seen with increasing frequency in the United States.1 The diagnosis is based on the typical constellation of signs and symptoms.1,2 Mortality is 1% to 2%, and significant morbidity results from aneurysmal formation in midsize arteries, especially the coronary arteries, which may result in rupture or myocardial infarction. We report an unusual case of Kawasaki disease. The initial febrile illness was an atypical presentation. A large abdominal aortic aneurysm developed, which subsequently was resected. Seven months after the febrile illness an asymptomatic myocardial infarction secondary to bilateral coronary arterial aneurysms was documented.

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