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image of Infectious Associations in Childhood Kawasaki Disease

Abstract

Kawasaki disease is a systemic vasculitis syndrome that is common in young children in the East, with potential life-threatening complications. Traditionally considered an autoimmune disease potentially triggered by infection without a specific causative pathogen, the increasing use of multiplexed PCR has allowed the association of infectious agents with Kawasaki disease to be determined. Here, we examined the clinical course of Kawasaki disease in six young children (age range: 3 months to 2 years) and discussed the laboratory findings and potential diagnostic pitfalls in these patients. We demonstrated that a diverse spectrum of respiratory and enteropathic pathogens could be found in the nasopharyngeal secretions or stool samples from these patients, confirming a strong correlation between infection and the initiation of this autoimmune process. Because the timely management of Kawasaki disease is important to prevent coronary aneurysms in these children, a high index of clinical suspicion is necessary to diagnose Kawasaki disease in the presence of unusual signs that emerge in a febrile child.

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2025-07-31
2025-12-14

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References

  1. Kim D.S. Kawasaki Disease. Yonsei Med. J. 2006 47 6 759 772 10.3349/ymj.2006.47.6.759 17191303
    [Google Scholar]
  2. McCrindle B.W. Rowley A.H. Newburger J.W. Burns J.C. Bolger A.F. Gewitz M. Baker A.L. Jackson M.A. Takahashi M. Shah P.B. Kobayashi T. Wu M.H. Saji T.T. Pahl E. American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young; Council on Cardiovascular and Stroke Nursing; Council on Cardiovascular Surgery and Anesthesia; and Council on Epidemiology and Prevention Diagnosis, treatment, and long-term management of kawasaki disease: A scientific statement for health professionals from the american heart association. Circulation 2017 135 17 e927 e999 10.1161/CIR.0000000000000484 28356445
    [Google Scholar]
  3. Ramphul K. Mejias S.G. Kawasaki disease: A comprehensive review. Arch. Med. Sci. Atheroscler. Dis. 2018 3 1 41 45 10.5114/amsad.2018.74522 30775588
    [Google Scholar]
  4. Patel R.M. Shulman S.T. Kawasaki disease: A comprehensive review of treatment options. J. Clin. Pharm. Ther. 2015 40 6 620 625 10.1111/jcpt.12334 26547265
    [Google Scholar]
  5. Soni P.R. Noval Rivas M. Arditi M. A comprehensive update on kawasaki disease vasculitis and myocarditis. Curr. Rheumatol. Rep. 2020 22 2 6 10.1007/s11926‑020‑0882‑1 32020498
    [Google Scholar]
  6. Agarwal S. Agrawal D.K. Kawasaki disease: Etiopathogenesis and novel treatment strategies. Expert Rev. Clin. Immunol. 2017 13 3 247 258 10.1080/1744666X.2017.1232165 27590181
    [Google Scholar]
  7. Rowley A.H. Baker S.C. Orenstein J.M. Shulman S.T. Searching for the cause of Kawasaki disease — cytoplasmic inclusion bodies provide new insight. Nat. Rev. Microbiol. 2008 6 5 394 401 10.1038/nrmicro1853 18364728
    [Google Scholar]
  8. Marrani E. Burns J.C. Cimaz R. How should we classify kawasaki disease? Front. Immunol. 2018 9 2974 10.3389/fimmu.2018.02974 30619331
    [Google Scholar]
  9. Rowley A.H. Shulman S.T. The epidemiology and pathogenesis of kawasaki disease. Front Pediatr. 2018 6 374 10.3389/fped.2018.00374 30619784
    [Google Scholar]
  10. Lo M.S. LoMS A framework for understanding Kawasaki disease pathogenesis. Clin. Immunol. 2020 214 108385 10.1016/j.clim.2020.108385 32173601
    [Google Scholar]
  11. Nakamura Y. Yashiro M. Uehara R. Oki I. Watanabe M. Yanagawa H. Monthly observation of the number of patients with Kawasaki disease and its incidence rates in Japan: Chronological and geographical observation from nationwide surveys. J. Epidemiol. 2008 18 6 273 279 10.2188/jea.JE2008030 19075496
    [Google Scholar]
  12. Rowley A.H. Is Kawasaki disease an infectious disorder? Int. J. Rheum. Dis. 2018 21 1 20 25 10.1111/1756‑185X.13213 29105346
    [Google Scholar]
  13. Freeman A.F. Shulman S.T. Recent developments in Kawasaki disease. Curr. Opin. Infect. Dis. 2001 14 3 357 361 10.1097/00001432‑200106000‑00017 11964855
    [Google Scholar]
  14. Rowley A.H. Understanding SARS-CoV-2-related multisystem inflammatory syndrome in children. Nat. Rev. Immunol. 2020 20 8 453 454 10.1038/s41577‑020‑0367‑5 32546853
    [Google Scholar]
  15. Galeotti C. Bayry J. Autoimmune and inflammatory diseases following COVID-19. Nat. Rev. Rheumatol. 2020 16 8 413 414 10.1038/s41584‑020‑0448‑7 32499548
    [Google Scholar]
  16. Sharma C. Ganigara M. Galeotti C. Burns J. Berganza F.M. Hayes D.A. Singh-Grewal D. Bharath S. Sajjan S. Bayry J. Multisystem inflammatory syndrome in children and Kawasaki disease: A critical comparison. Nat. Rev. Rheumatol. 2021 17 12 731 748 10.1038/s41584‑021‑00709‑9 34716418
    [Google Scholar]
  17. Leung K.K.Y. Hon K.L. Wang M.H.T. Ng D.K.K. Ip P. Paediatric multisystem inflammatory syndrome and COVID-19: another novel syndrome? Hong Kong Med J 2021 27 2 161 162 10.12809/hkmj208681 33843609
    [Google Scholar]
  18. Kaushik A. Gupta S. Sood M. Sharma S. Verma S. A systematic review of multisystem inflammatory syndrome in children associated with sars-cov-2 infection. Pediatr. Infect. Dis. J. 2020 39 11 e340 e346 10.1097/INF.0000000000002888 32925547
    [Google Scholar]
  19. Hon K.L.E. Leung K.K.Y. HonKLE Pediatric COVID-19: What disease is this? World J. Pediatr. 2020 16 4 323 325 10.1007/s12519‑020‑00375‑z 32556887
    [Google Scholar]
  20. Lin J. Harahsheh A.S. Raghuveer G. Jain S. Choueiter N.F. Garrido-Garcia L.M. Dahdah N. Portman M.A. Misra N. Khoury M. Fabi M. Elias M.D. Dionne A. Lee S. Tierney E.S.S. Ballweg J.A. Manlhiot C. McCrindle B.W. Emerging insights into the pathophysiology of multisystem inflammatory syndrome associated with covid-19 in children. Can. J. Cardiol. 2023 39 6 793 802 10.1016/j.cjca.2023.01.002 36626979
    [Google Scholar]
  21. Abrams J.Y. Godfred-Cato S.E. Oster M.E. Chow E.J. Koumans E.H. Bryant B. Leung J.W. Belay E.D. Multisystem inflammatory syndrome in children associated with severe acute respiratory syndrome coronavirus 2: A systematic review. J. Pediatr. 2020 226 45 54.e1 10.1016/j.jpeds.2020.08.003 32768466
    [Google Scholar]
  22. Jiang L. Tang K. Levin M. Irfan O. Morris S.K. Wilson K. Klein J.D. Bhutta Z.A. COVID-19 and multisystem inflammatory syndrome in children and adolescents. Lancet Infect. Dis. 2020 20 11 e276 e288 10.1016/S1473‑3099(20)30651‑4 32818434
    [Google Scholar]
  23. Feldstein L.R. Rose E.B. Horwitz S.M. Collins J.P. Newhams M.M. Multisystem inflammatory syndrome in U.S. children and adolescents. N Engl J Med 2020 383 4 334 346 10.1056/NEJMoa2021680 32598831 PMC7346765
    [Google Scholar]
  24. Şener S. Batu E. Akca Ü.K. Atalay E. Cüceoğlu M.K. Balık Z. Başaran Ö. Karagöz T. Özsürekçi Y. Bilginer Y. Özen S. Differentiating multisystem inflammatory syndrome in children from kawasaki disease during the pandemic. Turk. Arch. Pediatr. 2024 59 2 150 156 10.5152/TurkArchPediatr.2024.23192 38454223
    [Google Scholar]
  25. Alkan F. Bircan O. Bal A. Bayturan S. Zengin N. Coskun S. Comparison of early characteristics of multisystemic inflammatory syndrome and Kawasaki disease in children and the course of Kawasaki disease in the pandemic. BMC Pediatr. 2024 24 1 485 10.1186/s12887‑024‑04966‑x 39080588
    [Google Scholar]
  26. Noval Rivas M. Arditi M. Kawasaki disease and multisystem inflammatory syndrome in children. Rheum. Dis. Clin. North Am. 2023 49 3 647 659 10.1016/j.rdc.2023.03.002 37331738
    [Google Scholar]
  27. Gómez-Rial J. Rivero-Calle I. Salas A. Martinón-Torres F. Gómez-RialJ Rotavirus and autoimmunity. J. Infect. 2020 81 2 183 189 10.1016/j.jinf.2020.04.041
    [Google Scholar]
  28. Kaufhold R.M. Field J.A. Caulfield M.J. Wang S. Joseph H. Wooters M.A. Green T. Clark H.F. Krah D. Smith J.G. Memory T-cell response to rotavirus detected with a gamma interferon enzyme-linked immunospot assay. J. Virol. 2005 79 9 5684 5694 10.1128/JVI.79.9.5684‑5694.2005 15827183
    [Google Scholar]
  29. Honeyman M.C. Stone N.L. Harrison L.C. T-cell epitopes in type 1 diabetes autoantigen tyrosine phosphatase IA-2: potential for mimicry with rotavirus and other environmental agents. Mol Med 1998 4 4 231 239 9606176 PMC2230363
    [Google Scholar]
  30. Ha E.K. Kim J.H. Cha H.R. Lee G.C. Shin J. Shin Y.H. Baek H.S. Lee S.W. Han M.Y. Rotavirus-associated hospitalization in children with subsequent autoimmune disease. JAMA Netw. Open 2023 6 7 e2324532 10.1001/jamanetworkopen.2023.24532 37494043
    [Google Scholar]
  31. Chang L.Y. Lu C.Y. Shao P.L. Lee P.I. Lin M.T. Fan T.Y. Cheng A.L. Lee W.L. Hu J.J. Yeh S.J. Chang C.C. Chiang B.L. Wu M.H. Huang L.M. Viral infections associated with Kawasaki disease. J. Formos. Med. Assoc. 2014 113 3 148 154 10.1016/j.jfma.2013.12.008 24495555
    [Google Scholar]
  32. Fukui S. Seki M. Minami T. Kotani K. Oka K. Yokomizo A. Matsubara D. Sato T. Nozaki Y. Saito M. Kikuchi Y. Miyamoto K. Monden Y. Yamagata T. Efficacy and safety associated with the infusion speed of intravenous immunoglobulin for the treatment of Kawasaki disease: A randomized controlled trial. Pediatr. Rheumatol. Online J. 2021 19 1 107 10.1186/s12969‑021‑00601‑6 34217297
    [Google Scholar]
  33. Loo S.K. Hon K.L. Leung A.K.C. Yung T.C. Yam M.C. LooSKF Kawasaki disease in siblings and a review of drug treatment. Drugs Context 2020 9 1 5 10.7573/dic.2020‑4‑1
    [Google Scholar]
  34. Zhu F. Ang J.Y. 2021 Update on the Clinical Management and Diagnosis of Kawasaki Disease. Curr. Infect. Dis. Rep. 2021 23 3 3 10.1007/s11908‑021‑00746‑1 35194409
    [Google Scholar]
  35. Brogan P. Burns J.C. Cornish J. Diwakar V. Eleftheriou D. Gordon J.B. Gray H.H. Johnson T.W. Levin M. Malik I. MacCarthy P. McCormack R. Miller O. Tulloh R.M.R. Kawasaki Disease Writing Group, on behalf of the Royal College of Paediatrics and Child Health, and the British Cardiovascular Society Lifetime cardiovascular management of patients with previous Kawasaki disease. Heart 2020 106 6 411 420 10.1136/heartjnl‑2019‑315925 31843876
    [Google Scholar]
  36. Mori M. Imagawa T. Yasui K. Kanaya A. Yokota S. Predictors of coronary artery lesions after intravenous γ-globulin treatment in Kawasaki disease. J. Pediatr. 2000 137 2 177 180 10.1067/mpd.2000.107890 10931408
    [Google Scholar]
  37. Harada K. Intravenous gamma-globulin treatment in Kawasaki disease. Acta Paediatr Jpn 1991 33 6 805 810 10.1111/j.1442‑200x.1991.tb02612.x 1801561
    [Google Scholar]
  38. Koren G. Lavi S. Rose V. Rowe R. Kawasaki disease: Review of risk factors for coronary aneurysms. J. Pediatr. 1986 108 3 388 392 10.1016/S0022‑3476(86)80878‑2 3950818
    [Google Scholar]
  39. Leung A.K.C. Sergi C.M. Leong K.F. Kantor P.F. Md Visual Diagnosis: High fever, maculopapular rash, perianal desquamation, and conjunctivitis in a 3-year-old Boy. Pediatr. Rev. 2021 42 5 e17 e22 10.1542/pir.2018‑0330 33931516
    [Google Scholar]
/content/journals/cpr/10.2174/0115733963361845250728054225
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Infectious Associations in Childhood Kawasaki Disease
Bentham Science Publishers ; https://doi.org/10.2174/0115733963361845250728054225
/content/journals/cpr/10.2174/0115733963361845250728054225
/content/journals/cpr/10.2174/0115733963361845250728054225
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  • Article Type:     Editorial
Keywords: Kawasaki disease, systemic vasculitis syndrome, PCR, respiratory pathogens, enteropathic pathogens, febrile child

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