[Previous or coincident infections with suspected Kawasaki disease. Should we change our approach?]

Area of Science:

• Pediatrics
• Infectious Diseases
• Cardiology

Background:

• Kawasaki disease (KD) is a critical pediatric vasculitis impacting multiple systems, notably coronary arteries.
• Infections are suspected triggers for KD inflammation, necessitating investigation into their role.
• Understanding the link between infections and KD complications is vital for timely diagnosis and management.

Purpose of the Study:

• To determine the prevalence of infections in children diagnosed with Kawasaki disease.
• To analyze clinical features and coronary artery abnormalities in KD patients with concurrent infections.
• To investigate the association between positive microbiological findings (PMF) or previous recent infection (PRI) and KD outcomes.

Main Methods:

• A retrospective analysis of 621 children with KD was conducted from 2011-2016.
• Patients were categorized based on positive microbiological findings (PMF) or previous recent infection (PRI) within 4 weeks of KD diagnosis.
• Echocardiographic data and clinical characteristics were compared between infected and non-infected KD groups.

Main Results:

• 16.3% of KD patients had PMF, and 17.2% had a PRI.
• The PRI group showed significantly fewer echocardiographic abnormalities (23% vs. 35%) and overall coronary artery lesions (16% vs. 25%) compared to those without PRI.
• No significant differences in coronary aneurysm incidence were observed between groups with or without PRI or PMF.

Conclusions:

• The presence of a recent infection or positive microbiological findings in KD patients does not correlate with an increased incidence of coronary aneurysms.
• These findings support initiating prompt Kawasaki disease treatment regardless of a confirmed concurrent infection.
• Further research may elucidate specific infectious triggers and their precise impact on KD pathogenesis.