Infectious associations in childhood Kawasaki Disease

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.