Background: Kawasaki disease is a self-limited disease but it can lead to potentially fatal cardiac complications if not detected and managed accordingly. Objective: To determine the incidence of cardiac involvement in patients with Kawasaki disease admitted in PGH Methods: Medical records of patients with KD admitted from January 2012 to December 2013 were reviewed. Demographic, clinical, laboratory, chest radiographic, electrocardiographic, and echocardiographic data were recorded. The course, management, length of hospital stay, clinical outcome, duration of OPD follow-up, and medications were evaluated. Results: Thirty-eight patients with mean age of 2.67 ± 2.26 years old, 66% males with KD were included. Fifty-nine percent had cardiac involvement, and among those with cardiac involvement, 68% have coronary artery dilatation. Seventy-six percent of cases received intravenous immunoglobulin (IVIG) with 55% receiving IVIG within 10 days of illness. The initial cardiac findings resolved in the subsequent 2d-echo after IVIG except for some coronary artery abnormalities, which resolved in 5 ± 3.11 months during follow-up. There was no mortality. The possible predictive factors for the development of cardiac abnormalities published in other studies were not found to be significantly associated in this study population. Conclusion The incidence of cardiac involvement in patients with Kawasaki disease among children admitted in PGH is 59% with68% having coronary artery dilatation, higher than in other published studies.
Mucocutaneous Lymph Node Syndrome ; Immunoglobulins, Intravenous

Paradoxical response to anti-tuberculosis treatment, defined as clinical or radiologic worsening of pre-existing lesions or the development of new lesions while ongoing treatment, poses diagnostic dilemma. Intestinal perforation as a paradoxical response is rare. We report a 10-year-old female who presented with recurrent abdominal pain, anorexia, and bloody diarrhea, and was diagnosed with disseminated tuberculosis. She had marked improvement after one month of anti-tuberculosis treatment but developed a recurrence of initial symptoms on the third month of therapy and was treated for cecal perforation. Histopathology of cecum revealed chronic granulomatous inflammation. The patient improved after the surgery and the resumption of anti-tuberculosis medications. Recognition of paradoxical reactions and differentiating it from drug resistance of other pathology is important as these necessitates different management strategies.
Human ; Female ; Child: 6-12 yrs old ; intestinal perforation