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Volume 39, Number 5, October 2006

Kawasaki disease in infants three months of age or younger


Chih-Hsien Chuang, Ming-Hsien Hsiao, Cheng-Hsun Chiu, Yhu-Chering Huang, Tzou-Yien Lin
Department of Pediatrics, Chang Gung Children’s Hospital, Kweishan, Taoyuan; and Department of Pediatrics, St. Paul’s Hospital, Taoyuan, Taiwan

Received: June 11, 2005    Revised: August 20, 2005    Accepted: September 10, 2005   

 

Corresponding author:

Dr. Cheng-Hsun Chiu, Department of Pediatrics, Chang Gung Children’s Hospital, 5 Fu-Hsin Street, Kweishan 333, Taoyuan, Taiwan. E-mail: chchiu@adm.cgmh.org.tw This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

 



 

Background and purpose: 

Kawasaki disease (KD) is rare in infants ≤ 3 months of age. This study analyzed the features of KD in 25 infants ≤3 months of age treated from February 1994 to December 2004.

 



 

Methods:

Basic characteristics, clinical, laboratory, echocardiographic, therapeutic, and follow-up data of the infants were obtained from chart records.

 



 

Results:

There were 19 male and 6 female infants in this cohort. The frequency of the 5 principal clinical features was as follows: changes in lips and oral cavity, 84%; bilateral bulbar conjunctival injection without exudates, 80%; polymorphous exanthem, 68%; cervical lymphadenopathy, 28%; and changes in extremities, 24%. Six infants (24%) fulfilled criteria for KD including fever which persists for 5 or more days with at least 4 of the principal clinical criteria, and the remaining infants were classified as having incomplete KD (all of whom showed coronary involvement). Coronary artery dilatation was found in 20 infants (80%). One infant developed a medium-size aneurysm (5.2 mm), while the others had only coronary arterial ectasia or small aneurysms. Coronary artery aneurysms regressed within 1-year follow-up in all but one infant. No fatal or recurrent case was observed during the study period.
 



 

Conclusion:

Infants ≤3 months of age with KD usually presented with incomplete clinical features. A high proportion of coronary artery involvement was observed in this series. Echocardiography should be considered in very young infants with unexplained prolonged fever who do not present all of the principal clinical features of KD.

 



 

Key words:

Coronary aneurysm, disease progression, infant, mucocutaneous lymph node syndrome, newborn infant

 



 

J Microbiol Immunol Infect2006;39:387-391.