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World Journal of Pediatrics

, Volume 14, Issue 6, pp 621–622 | Cite as

Antibiotic use in children with Kawasaki disease

  • Seung Beom Han
  • Soo-Young LeeEmail author
Letter to the Editor

As the diagnostic criteria for Kawasaki disease (KD) consist of the clinical features that are shared by other childhood febrile illnesses [1, 2], KD is sometimes confused with a bacterial infection, leading to clinical situations in which children with the disease receive antibiotics [3, 4, 5]. Here, we report the extent of antibiotic use in children with KD and the clinical parameters confusing KD with a bacterial infection.

In this retrospective study, medical records for 140 children (86 boys) who were diagnosed with KD at a university hospital in Seoul, between January 2015 and December 2016, were reviewed. Diagnosis of KD was based on American Heart Association criteria [2]. All children with KD received treatment with intravenous immunoglobulin (IVIG, 2 g/kg/dose) and underwent echocardiography during hospitalization.

Of the children with KD, 54.3% (76/140) received treatment with intravenous antibiotics (ampicillin/sulbactam or cefotaxime 100–200 mg/kg/day) before the diagnosis...

Notes

Author contributions

SBH collected data. SYL conceived the study, statistical analysis, and drafted the manuscript. Both authors approved the final version of the manuscript.

Funding

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (2017R1D1A1B03029968).

Compliance with ethical standards

Ethical approval

The study protocol was approved by the Institutional Review Board of St. Paul's Hospital, College of Medicine, The Catholic University of Korea (PC17REDI0038). Informed consent was waived for this study.

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Kawasaki T, Kosaki F, Okawa S, Shigematsu I, Yanagawa H. A new infantile acute febrile mucocutaneous lymph node syndrome (MLNS) prevailing in Japan. Pediatrics. 1974;54:271–6.PubMedPubMedCentralGoogle Scholar
  2. 2.
    McCrindle BW, Rowley AH, Newburger JW, Burns JC, Bolger AF, Gewitz M, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a scientific statement for health professionals from the American Heart Association. Circulation. 2017;135:e927–99.CrossRefGoogle Scholar
  3. 3.
    Ristoska-Bojkovska N, Stavric K, Tasic V. Kawasaki disease misdiagnosed as acute pyelonephritis. Pediatr Nephrol. 2003;18:851–2.CrossRefGoogle Scholar
  4. 4.
    Benseler SM, McCrindle BW, Silverman ED, Tyrrell PN, Wong J, Yeung RS. Infections and Kawasaki disease: implications for coronary artery outcome. Pediatrics. 2005;116:e760–6.CrossRefGoogle Scholar
  5. 5.
    Wu CY, Hsieh KS, Chiou YH, Wang RS, Huang IF, Lee WY, et al. Prolonged fever and pyuria: a urinary tract infection presentation of incomplete Kawasaki disease. Acta Paediatr. 2005;94:375–7.CrossRefGoogle Scholar
  6. 6.
    Han SB, Lee SY, Jeong DC. The presence of coronary artery lesions may indicate the severity of the inflammation rather than the cause. Semin Arthritis Rheum. 2017;47:e6.CrossRefGoogle Scholar
  7. 7.
    Jan SL, Wu MC, Lin MC, Fu YC, Chan SC, Lin SJ. Pyuria is not always sterile in children with Kawasaki disease. Pediatr Int. 2010;52:113–7.CrossRefGoogle Scholar
  8. 8.
    Barone SR, Pontrelli LR, Krilov LR. The differentiation of classic Kawasaki disease, atypical Kawasaki disease, and acute adenoviral infection: use of clinical features and a rapid direct fluorescent antigen test. Arch Pediatr Adolesc Med. 2000;154:453–6.CrossRefGoogle Scholar

Copyright information

© Children's Hospital, Zhejiang University School of Medicine 2018

Authors and Affiliations

  1. 1.Department of Pediatrics, College of MedicineThe Catholic University of KoreaSeoulRepublic of Korea
  2. 2.Department of Pediatrics, St. Paul’s Hospital, College of MedicineThe Catholic University of KoreaSeoulRepublic of Korea

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