Search

Kawasaki disease is a medium-size vasculitis with peak incidence among infants of 9 to 11 month age. This case report represents a female infant of 18-month age whom was admitted to the Taleghani Pediatric Center of Gorgan, Iran; with referral for admission due to persistent fever for roughly 2 weeks despite various outpatient treatments. Upon the admission, Echocardiographic study was performed to assess whether the patient fulfils cardiac criteria of Kawaski disease which was consistent with the diagnosis and also positive for serious coronary complications in the infant. General condition of the patient improved as the treatment with both IVIG and Corticosteroids was initiated and carditis seemed to vanish in echocardiographic studies but as expected aneurysmal growth can last for over 80 days and in this case serial echocardiographic studies confirmed the formation of giant coronary aneurysms. Diagnosis of Kawasaki disease is based on persistent fever and consistency with clinical criteria and the main purpose of this case report was to emphasize the need to consider this disease in cases of persistent fever to avoid the serious following complications.

Background: Purulent cervical lymphadenitis presents with different manifestations such as fever and Erythema of the skin at the site of infection. The appropriate treatment for purulent lymphadenitis are antibiotics. If there is no response to antibiotic treatment, other causes should be considered, including uncommon infectious causes (for example Mycobacterium infections or fungal infections), malignancy and Kawasaki diseases, etc. This study aimed to introduce a child with suspected purulent cervical lymphadenitis, who was initially presented with purulent lymphadenitis and was treated with broad-spectrum antibiotics. Due to the lack of response to treatment, further laboratory and clinical examinations were performed for him, then he was diagnosed with Kawasaki disease. Case Presentation: A 10-year-old boy with fever and severe cervical lymphadenitis was referred to Tehran Childrenchr('39')s Medical Center Hospital in May 2018. He had leukocytosis in his lab test and the acute reactant phase was high. He was diagnosed with purulent lymphadenitis and he was treated with broad-spectrum antibiotics. But no therapeutic response was observed, the patientchr('39')s fever continued and erythrocyte sedimentation rate (ESR) increased in the laboratory tests. The patientchr('39')s knee developed arthralgia, and Inflammation of the neck spread to the chest wall. Therefore echocardiography was performed. The patientchr('39')s left anterior descending artery (LAD) had ectasia in echocardiography (LAD>2/5 SD). The patient was diagnosed with atypical Kawasaki disease, therefore the appropriate treatment was started for him and a dramatic clinical response was seen. His fever stopped and the patientchr('39')s cervical lymphadenitis had completely improved. In the follow-up, the patientchr('39')s left anterior descending artery (LAD) ectasia was resolved. Conclusion: Kawasaki disease is one of the causes of cervical lymphadenitis in children. If a patient with suspected purulent lymphadenitis is treated with appropriate antibiotics but no adequate response is seen, Kawasaki disease should be considered and the patient must be re-evaluated for Kawasaki disease.

BACKGROUND AND OBJECTIVE: Kawasaki disease is an acute vasculitis of childhood and can be associated with complications such as hyponatremia. The present study was conducted to evaluate the serum sodium levels and its association with cardiac complications in children with Kawasaki disease. METHODS: In this cross-sectional study, all Kawasaki patients (according to AHA criteria) referred to Amirkola Children's Hospital in Babol in 2017-2018 were evaluated. Patients underwent serum sodium assessment and echocardiography and the relationship between serum sodium levels and cardiac complications including ectasia and coronary aneurysm, myocarditis, pericarditis and coronary artery occlusion was investigated. FINDINGS: Of the 60 patients with Kawasaki disease, 27 (45%) were male and 33 (55%) were female. Their mean age was 32±8 months. 28 patients (47%) had serum sodium levels lower than 135 mEq/L while normal serum sodium level (135-150 mEq/L1) was reported in 53% of patients. Cardiac complications including coronary ectasia and myocarditis were reported in 16 and 32 patients, respectively. There was no significant difference between serum sodium levels and cardiac complications. There was no difference in the incidence of cardiac complications and hyponatremia in males and females. CONCLUSION: According to the results of the present study, serum sodium levels cannot be a good criterion for cardiac prognosis.

Kawasaki disease is a medium-size vasculitis with peak incidence among infants of 9 to 11 month age. This case report represents a female infant of 18-month age whom was admitted to the Taleghani Pediatric Center of Gorgan, Iran; with referral for admission due to persistent fever for roughly 2 weeks despite various outpatient treatments. Upon the admission, Echocardiographic study was performed to assess whether the patient fulfils cardiac criteria of Kawaski disease which was consistent with the diagnosis and also positive for serious coronary complications in the infant. General condition of the patient improved as the treatment with both IVIG and Corticosteroids was initiated and card it is seemed to vanish in echocardiographic studies but as expected aneurysmal growth can last for over 80 days and in this case serial echocardiographic studies confirmed the formation of giant coronary aneurysms. Diagnosis of Kawasaki disease is based on persistent fever and consistency with clinical criteria and the main purpose of this case report was to emphasize the need to consider this disease in cases of persistent fever to avoid the serious following complications. [ABSTRACT FROM AUTHOR]

Background: Purulent cervical lymphadenitis presents with different manifestations such as fever and Erythema of the skin at the site of infection. The appropriate treatment for purulent lymphadenitis are antibiotics. If there is no response to antibiotic treatment, other causes should be considered, including uncommon infectious causes (for example Mycobacterium infections or fungal infections), malignancy and Kawasaki diseases, etc. This study aimed to introduce a child with suspected purulent cervical lymphadenitis, who was initially presented with purulent lymphadenitis and was treated with broad-spectrum antibiotics. Due to the lack of response to treatment, further laboratory and clinical examinations were performed for him, then he was diagnosed with Kawasaki disease. Case Presentation: A 10-year-old boy with fever and severe cervical lymphadenitis was referred to Tehran Children's Medical Center Hospital in May 2018. He had leukocytosis in his lab test and the acute reactant phase was high. He was diagnosed with purulent lymphadenitis and he was treated with broad-spectrum antibiotics. But no therapeutic response was observed, the patient's fever continued and erythrocyte sedimentation rate (ESR) increased in the laboratory tests. The patient's knee developed arthralgia, and Inflammation of the neck spread to the chest wall. Therefore echocardiography was performed. The patient's left anterior descending artery (LAD) had ectasia in echocardiography (LAD>2/5 SD). The patient was diagnosed with atypical Kawasaki disease, therefore the appropriate treatment was started for him and a dramatic clinical response was seen. His fever stopped and the patient's cervical lymphadenitis had completely improved. In the follow-up, the patient's left anterior descending artery (LAD) ectasia was resolved. Conclusion: Kawasaki disease is one of the causes of cervical lymphadenitis in children. If a patient with suspected purulent lymphadenitis is treated with appropriate antibiotics but no adequate response is seen, Kawasaki disease should be considered and the patient must be re-evaluated for Kawasaki disease. [ABSTRACT FROM AUTHOR]

Introduction: Coronary artery aneurysms (CAAs) and ectasia (CAE) are diseases that have been increasingly noticed as the increase in utilization of coronary angiograms. Objective: The aim of this study is to determine the prevalence of coronary artery aneurysms and ectasia and describe the patients admitted to a private clinic in 2012 to 2014. Materials and Methods: This is a retrospective cross-sectional study involved all patient with invasive coronary angiogram that was performed at Dr.Heshmat and Golsar hospital in Rasht from may 2012 to may 2014. All data included cardiovascular disease major rick factors, demographic and angiographic characteristics were recorded in check list. Statistical analyses were performed by using SPSS version 19. Results: A total of 1705 coronary angiography were performed during the period of the study. CAE was found in 216 patients (12.7 % of all coronary angiograms). The majority (54.6%) were male. The mean age was 61.34±9.44 years (range, 30 to 83 years). CAE was associated with significant coronary artery stenosis in 123 patients (56.9%).The frequency of arterial involvement was: the right coronary artery (RCA) 56.9 %; left circumflex artery (LCx), 56.9%; the left anterior descending artery (LAD), 51.9 %.Coronary ectasia involved a single vessel in 50.9 %, two vessels in26.9 %, and three vessels in 20.4 %. Hyperlipidemia (81.5%) and hypertension (73.6%) were also most comorbidty in these patients. Coronary artery aneurysm was found in 7 patients (0.4% of all coronary angiograms). Conclusion: The prevalence of coronary artery ectasia in this study among patient who went for coronary angiography is higher than what has been published in others studies [ABSTRACT FROM AUTHOR]

A child with aggressive and resistant Kawasaki disease with coronary aneurysm is described. Despite two doses of immune globulin and high dose of aspirin the patient was treated with the third dose of immune globulin. The patient apparently responded to normalization of symptoms and signs, with no more progression of coronary artery abnormalities.