Otorhinolaryngological manifestations and delayed diagnosis in Kawasaki disease
Copyright © 2019 Elsevier B.V. All rights reserved..
OBJECTIVES: Kawasaki disease (KD) is a febrile multisystemic vasculitis of unknown etiology whose coronary prognosis is improved by early diagnosis and management. The objective of this study was to describe ENT manifestations encountered and to look for a delayed diagnosis associated with these manifestations.
METHODS: A retrospective descriptive single-center study was conducted in Lyon between January 2009 and December 2017. All children treated for Kawasaki disease were included in the study. Clinical, biological and cardiac ultrasound data were collected. According to the diagnosis made at the first medical visit, children were classified into two groups: diagnosis of ENT spectrum or non-ENT diagnosis. The diagnostic times were compared by a Student test.
RESULTS: 142 patients were included: 64 in the ENT diagnostic group, 78 in the non-ENT diagnostic group. When the initial diagnosis was of ENT spectrum, the diagnostic time of KD was significantly longer: 8.51 days vs 5.77 days - (p < 0.01). The total duration of fever was also longer - 10.92 vs 8.32 days - (p = 0.013) - and the frequency of antibiotics intake more important - 92.2% vs 46.2% - (p < 0.01). Four children underwent surgery in the ENT diagnostic group: two retro-pharyngeal abscesses, one paracentesis and one cervicectomy.
CONCLUSIONS: ENT manifestations are frequently at the forefront of KD and constitute a misleading clinical picture responsible for delayed diagnosis and potentially inappropriate medico-surgical management. It is necessary to provide more education to practitioners for earlier recognition of Kawasaki disease.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:121 |
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| Enthalten in: |
International journal of pediatric otorhinolaryngology - 121(2019) vom: 05. Juni, Seite 137-142 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Rouault, M [VerfasserIn] |
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| Links: |
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| Themen: |
Anti-Bacterial Agents |
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| Anmerkungen: |
Date Completed 22.07.2019 Date Revised 22.07.2019 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.ijporl.2019.02.035 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM295264411 |
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| 500 | |a Date Completed 22.07.2019 | ||
| 500 | |a Date Revised 22.07.2019 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2019 Elsevier B.V. All rights reserved. | ||
| 520 | |a OBJECTIVES: Kawasaki disease (KD) is a febrile multisystemic vasculitis of unknown etiology whose coronary prognosis is improved by early diagnosis and management. The objective of this study was to describe ENT manifestations encountered and to look for a delayed diagnosis associated with these manifestations | ||
| 520 | |a METHODS: A retrospective descriptive single-center study was conducted in Lyon between January 2009 and December 2017. All children treated for Kawasaki disease were included in the study. Clinical, biological and cardiac ultrasound data were collected. According to the diagnosis made at the first medical visit, children were classified into two groups: diagnosis of ENT spectrum or non-ENT diagnosis. The diagnostic times were compared by a Student test | ||
| 520 | |a RESULTS: 142 patients were included: 64 in the ENT diagnostic group, 78 in the non-ENT diagnostic group. When the initial diagnosis was of ENT spectrum, the diagnostic time of KD was significantly longer: 8.51 days vs 5.77 days - (p < 0.01). The total duration of fever was also longer - 10.92 vs 8.32 days - (p = 0.013) - and the frequency of antibiotics intake more important - 92.2% vs 46.2% - (p < 0.01). Four children underwent surgery in the ENT diagnostic group: two retro-pharyngeal abscesses, one paracentesis and one cervicectomy | ||
| 520 | |a CONCLUSIONS: ENT manifestations are frequently at the forefront of KD and constitute a misleading clinical picture responsible for delayed diagnosis and potentially inappropriate medico-surgical management. It is necessary to provide more education to practitioners for earlier recognition of Kawasaki disease | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Delayed diagnosis | |
| 650 | 4 | |a Kawasaki disease or Kawasaki syndrome | |
| 650 | 4 | |a Otolaryngological diseases | |
| 650 | 4 | |a Pediatric population | |
| 650 | 7 | |a Anti-Bacterial Agents |2 NLM | |
| 700 | 1 | |a Coudert, A |e verfasserin |4 aut | |
| 700 | 1 | |a Hermann, R |e verfasserin |4 aut | |
| 700 | 1 | |a Gillet, Y |e verfasserin |4 aut | |
| 700 | 1 | |a Truy, E |e verfasserin |4 aut | |
| 700 | 1 | |a Ayari-Khalfallah, S |e verfasserin |4 aut | |
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