Background: Kawasaki disease is an acute inflammatory disorder primarily affecting medium-sized blood vessels, especially in infants and young children under 5 years old, characterized by inflammation of the arterial walls, including coronary arteries. While predominantly affecting young children, rarely Kawasaki disease is seen in adults. Reporting this case is crucial due to the patient's very young age and the disease's unusual presentation following vaccination, contributing to the limited literature on Kawasaki disease in very young infants.
Case Presentation: A full-term, 2-month-and-10-day-old Iranian boy presented with persistent fever unresponsive to treatment, beginning 5 days after receiving the 5-in-1 vaccine. Although physical examination results were normal, his medical history included maternal hypothyroidism during pregnancy and neonatal jaundice that did not require hospitalization. Initial laboratory tests revealed bicytopenia, thrombocytosis on the complete blood count, and elevated erythrocyte sedimentation rate and C-reactive protein levels. Echocardiography identified giant coronary artery aneurysms. The patient was diagnosed with atypical Kawasaki disease and treated with intravenous immunoglobulin, methylprednisolone, infliximab, and aspirin, which resolved his fever.
Conclusions: This case emphasizes the importance of considering Kawasaki disease as a differential diagnosis in infants with persistent, treatment-resistant fever and abnormal complete blood count findings. Early diagnosis and timely intervention are essential to prevent severe complications, such as coronary artery aneurysms and possible mortality. It underscores the need for heightened awareness and vigilance among healthcare providers in similar clinical scenarios.
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http://dx.doi.org/10.1186/s13256-024-04987-1 | DOI Listing |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660496 | PMC |
Pediatr Rheumatol Online J
December 2024
Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Background: This study aims to develop Z-Score models to normalize measurements of three coronary arteries and enhance the diagnosis of Kawasaki disease (KD) in children from newborns to 10 years old. Developing a reliable Z-Score model is challenging, as some existing models fail the normality test. Overcoming these challenges is crucial for improving KD diagnosis.
View Article and Find Full Text PDFJ Card Fail
December 2024
Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan. Electronic address:
Background: To evaluate whether sodium zirconium cyclosilicate (SZC) enables the uptitration of spironolactone without increasing the risk of hyper- and hypokalemia in patients with heart failure with reduced and mildly reduced ejection fraction (HFrEF and HFmrEF) and moderate/severe chronic kidney disease (CKD) who developed hyperkalemia during treatment with suboptimal spironolactone dose.
Methods: The REGISTA-K is a randomized, double-blind, placebo-controlled, multicenter trial that examined the efficacy and safety of SZC in uptitrating spironolactone without the occurrence of hyperkalemia or hypokalemia. A total of 266 patients with HFrEF and HFmrEF and hyperkalemia will be randomized in a 1:1 ratio to receive either SZC or placebo after treating hyperkalemia with SZC at 25 sites in Japan.
Arch Virol
December 2024
Department of Medical Entomology, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan.
Most members of the genus Orthonairovirus, represented by Crimean-Congo hemorrhagic fever virus and Nairobi sheep disease virus, are tick-borne, and some have become a public health concern in recent years. Here, we report the isolation and genetic and biological characterization of a new orthonairovirus, designated as "Iwanai Valley virus" (IWVV), from Ixodes ovatus ticks in Hokkaido, Japan. The amino acid sequence of the viral nucleoprotein (NP) was found to be 34-45% identical to those of known orthonairoviruses.
View Article and Find Full Text PDFJ Med Case Rep
December 2024
Department of Pediatrics, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Cureus
November 2024
Department of Emergency Medicine, Gunma University Graduate School of Medicine, Maebashi, JPN.
Background: Out-of-hospital cardiac arrest (OHCA) has a poor prognosis. Patients with shockable rhythms often have better outcomes than those with nonshockable rhythms. A previous study reported a decline in shockable rhythms and poorer outcomes with the use of beta-blockers before OHCA.
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