Kawasaki disease (KD) is a common systemic vasculitis of childhood involving medium sized arteries that may result in life-threatening coronary artery abnormalities [1]. Children with Kawasaki disease generally do not develop shock however, in some patients a more intense inflammatory response may lead to shock syndrome [2]. This is a case of a seven-year-old male who presented with neck pain, fever, rash, and with clinical signs of poor perfusion and shock. 2D-echocardiography showed dilated coronary arteries, and he was managed as a case of Kawasaki Disease Shock Syndrome (KDSS).

OBJECTIVE: To determine the reliability and validity of the modified pediatric nutrition screening tool in identifying malnutrition and risk of malnutrition among admitted pediatric patients aged 6 to 18 years old. METHOD: The Modified Pediatric Nutritional Screening Tool (PNST) was used to assess 130 admitted patients aged 6 to 18 years old. Evaluation of anthropometric measurements, body weight changes, clinical conditions and dietary intake were done within 48 hours of admission. Intraclass correlation coefficient was used to determine reliability of the tool among different raters while chi square test was used to determine correlation of the tool with the Screening Tool for the Assessment for Malnutrition in Pediatrics (STAMP). RESULT: The comparison of the modified PNST measurements by two observers showed no significant difference with p value of 0.078. All PNST criteria except clinical condition were associated with risk of malnutrition based on STAMP. The overall modified PNST criteria is significantly associated with risk of malnutrition based on STAMP. CONCLUSION The modified PNST accurately identifies malnutrition and risk of malnutrition among admitted patients aged 6-18 years old. The criteria used in the modified PNST were strongly associated with risk for malnutrition measured using previously validated tools and demonstrates a good interobserver reliability. It is recommended to be used as routine screening in the hospital set- ting for early identification of malnutrition and risk for malnutrition.
Malnutrition ; Pediatrics