Kawasaki disease mimickers

Pediatr Int. 2021 Aug;63(8):880-888. doi: 10.1111/ped.14561. Epub 2021 Jul 16.

Abstract

Background: Kawasaki disease (KD) is an acute systemic vasculitis that predominantly affects patients younger than 5 years. In the absence of an available, affordable diagnostic test, detailed clinical history and physical examination are still fundamental to make a diagnosis.

Methods: We present five representative cases with KD-like presentations: systemic onset juvenile idiopathic arthritis, mycoplasma-induced rash and mucositis, staphylococcal scalded skin syndrome, BCGosis, and the recently described multisystemic inflammatory syndrome in children (MIS-C) associated with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) virus.

Results: Rash, fever, and laboratory markers of inflammation can be present in several childhood diseases that may mimic KD.

Conclusion: The term 'Kawasaki syndrome' instead of 'Kawasaki disease' may be more appropriate. Physicians should consider an alternative diagnosis that may mimic KD, particularly considering MIS-C during the present pandemic, as an aggressive diagnostic and therapeutic approach is needed.

Keywords: BCGosis; Kawasaki disease; MIRM; MIS-C; PIMS; SARS-Cov2; juvenile idiopathic arthritis.

Publication types

  • Case Reports

MeSH terms

  • COVID-19*
  • Child
  • Humans
  • Mucocutaneous Lymph Node Syndrome* / diagnosis
  • RNA, Viral
  • SARS-CoV-2
  • Systemic Inflammatory Response Syndrome

Substances

  • RNA, Viral

Supplementary concepts

  • pediatric multisystem inflammatory disease, COVID-19 related