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A 13-Year-Old Boy Who Has Kawasaki Disease Shock Syndrome Presents with Parotitis

Yilmaz Yozgat1, Selcuk Uzuner2, Aysegul Dogan Demir2

  • 1Department of Pediatric Cardiology, Bezmialem Vakif University, Istanbul, Turkey.

Journal of Pediatric Intensive Care
|January 28, 2020
PubMed

Insights

This case highlights Kawasaki disease shock syndrome (KDSS) in a boy with mumps and toxic shock-like syndrome. Early detection of coronary artery aneurysms is crucial in similar presentations.

Area of Science:

  • Pediatric Cardiology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Kawasaki disease shock syndrome (KDSS) is a severe manifestation of Kawasaki disease.
  • Mumps and toxic shock-like syndrome (TSLS) are distinct conditions that can present with overlapping symptoms.

Observation:

  • A 13-year-old boy presented with symptoms of TSLS and mumps, progressing to hemodynamic instability.
  • The patient required pediatric intensive care unit (PICU) admission with significant hypotension and delayed capillary refill.
  • Echocardiography revealed giant right coronary artery aneurysms, leading to a diagnosis of KDSS.

Findings:

  • This is the first reported case of KDSS associated with parotitis (mumps).
  • The co-occurrence of TSLS symptoms and mumps in this patient preceded the development of KDSS and coronary aneurysms.
  • Successful management involved fluid resuscitation and vasoactive infusion in the PICU.

Implications:

  • Clinicians should maintain a high index of suspicion for KDSS in pediatric patients presenting with concurrent mumps and TSLS symptoms.
  • Prompt echocardiographic evaluation is essential for detecting coronary artery aneurysms in patients at risk for KDSS.
  • This case underscores the importance of recognizing atypical presentations and potential complications of common childhood illnesses.

Keywords:
Kawasaki disease shock syndromeparotitistoxic shock syndrome

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