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Published on: February 23, 2024
[Diagnosis and treatment of Kawasaki disease in burn children]
Jie Feng1, Wei-ren Li, Wei Wang
1Department of Pediatrics, Guizhou Provincial People's Hospital, Guiyang 550004, China.
Insights
Kawasaki disease (KD) in burn children presents with fever and rash, potentially linked to burn wound pathogenesis. Early suspicion and treatment with gamma globulin or aspirin are crucial for recovery.
Area of Science:
- Pediatric Medicine
- Infectious Diseases
- Dermatology
Background:
- Investigating the co-occurrence and clinical presentation of Kawasaki disease (KD) in pediatric burn patients.
- Analyzing the potential link between burn injuries and the development of KD.
Observation:
- Reviewed one case of KD in a burn child locally and five from international literature.
- All six patients were males under five years old, experiencing varying burn severities.
- Common KD symptoms like fever, rash, conjunctivitis, and oral mucosal changes appeared shortly after burn injury.
Findings:
- Four to five classic KD symptoms were observed in burn patients presenting with fever and rash.
- Coronary artery dilatation was noted in one patient via echocardiography.
- Wound cultures were positive in two cases, while blood cultures were negative in all patients.
Implications:
- Suggests a potential role for burn wounds and edema reabsorption in KD pathogenesis.
- Highlights the importance of suspecting KD in young burn patients with concurrent fever and rash.
- Emphasizes prompt diagnosis and treatment with high-dose gamma globulin and/or aspirin for favorable outcomes.
Abstract:
We try to discuss the relationship between burn and Kawasaki disease (KD), and to study the diagnosis and treatment of KD in burn children. The medical records of one burn child with KD from our pediatric ward together with those of 5 burn children with KD retrieved from foreign literature were analyzed. The clinical features of KD, including bilateral nonexudative conjunctivitis, erythema of the lips and oral mucosa, skin rash, cervical lymphadenopathy, changes in the distal part of extremities, were enrolled in the study. Six patients were male and younger than 5 years old, with 2 suffering from mild burn, 2 with moderate burn, and 2 with severe burn. Two days after second degree burn, all burn children had fever and skin rash with 4 or 5 clinical symptoms and signs of KD. Among them, coronary artery dilatation was found in 1 case as detected by echocardiography, positive wound culture was found in 2 cases, negative blood culture was found in 6 cases. All patients were given high-dose gamma globulin or (and) aspirin within 10 days after the first fever, followed by control and amelioration of the disease. We conclude that the pathogenesis of KD may be related with burn wound and reabsorption of edema. KD may be suspected in burn children younger than 5 years when they had fever and skin rash at the same time.
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