Kawasaki Disease in Infants Aged 3 months and Younger: Diagnostic Significance of Erythema at the BCG Inoculation Site.
- Author:
Soo Jeong LEE
1
;
Sejung SOHN
Author Information
1. Department of Pediatrics, Ewha Womans University College of Medicine,Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Kawasaki disease;
BCG;
Infant
- MeSH:
Dilatation;
Erythema*;
Follow-Up Studies;
Humans;
Infant*;
Mitral Valve Insufficiency;
Mitral Valve Prolapse;
Mucocutaneous Lymph Node Syndrome*;
Mycobacterium bovis*;
Retrospective Studies
- From:Journal of the Korean Pediatric Cardiology Society
2004;8(1):148-155
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The purpose of this study was to determine whether erythema at the BCG inoculation site in young infants is likely to be a diagnostic clue to Kawasaki disease (KD). METHODS: A retrospective study was performed in infants with KD aged < or = 3 months treated at our hospital from January 1998 to August 2003. RESULTS: Of 428 patients treated during the study period, 14(3.3%) were < or = 3 months of age. Of them, 13 had atypical presentations, with fewer classic findings in the required criteria of KD. The most common findings were fever(100%) and oral mucosal changes(78.5%). Erythema at the BCG inoculation site was observed in at least nine patients. This feature proved to be a definite evidence of the disease in three patients who had developed cardiac complications, and a strong diagnostic clue in the remaining six patients not having cardiac complications. Seven patients(50%) had developed cardiac complications:coronary dilatation in four patients, coronary wall irregularity in two, and mitral valve prolapse with regurgitation in one. During follow-up for 6 to 20 months, cardiac complications disappeared in all patients except for one who had mitral regurgitation. CONCLUSION: Most patients with KD < or = 3 months of age have atypical presentations, with a high rate of cardiac complications. Erythema at the site of BCG inoculation could be used as a reliable diagnostic tool for atypical KD in this young age group.
