Erythema and induration of the Bacillus Calmette-Guérin site for diagnosing Kawasaki disease

Singapore Medical Journal
Ann LohZe Lei Tan

Abstract

Kawasaki disease (KD) is a challenging diagnosis. Erythema and induration of the Bacillus Calmette-Guérin (BCG) site is increasingly recognised as a significant clinical clue. However, there is little data to support its specificity for KD as compared to other febrile illnesses. We aimed to evaluate BCG reaction or induration as a diagnostic tool for KD. A retrospective case-controlled study of patients discharged with a diagnosis of KD from 2007 to 2010 was conducted. Another group of patients admitted over the same period for possible KD, but later found not to have KD, served as control. Significantly more infants with KD (69.7%) had BCG site changes than older children (27.8%; p < 0.001). It also presented earlier in the course of KD; < 5 days (53.3%) compared to ≥ 5 days of fever (30.0%; p < 0.001). Positive predictive value of BCG site reaction or induration for KD was 90.8% (95% confidence interval [CI] 0.819-0.962) for infants and 96.2% (95% CI 0.868-0.995) for older children. The prevalence rate of changes at the BCG site was 9.9% among patients with non-KD febrile illnesses and 42.6% among patients with KD. BCG site reaction or induration is a useful clinical clue for the diagnosis of KD in both infants and older chil...Continue Reading

References

May 1, 1993·Circulation·A S DajaniW Wilson
Dec 3, 2004·Pediatrics·Jane W NewburgerUNKNOWN Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American H
Mar 18, 2005·Pediatrics International : Official Journal of the Japan Pediatric Society·Mamoru AyusawaUNKNOWN Kawasaki Disease Research Committee
Aug 23, 2005·Archives of Disease in Childhood·R Sinha, T Balakumar
Dec 25, 2009·The Pediatric Infectious Disease Journal·Ritei UeharaHiroshi Yanagawa
Sep 6, 2011·Acta Pharmacologica Sinica·Ho-chang Kuo, Wei-chiao Chang
Feb 7, 2012·Journal of Epidemiology·Ritei Uehara, Ermias D Belay
Nov 10, 2012·The Tohoku Journal of Experimental Medicine·Yosuke KakisakaShigeo Kure
Nov 15, 2014·Materia Socio-medica·Mohammad Sadegh Rezai, Soheila Shahmohammadi

❮ Previous
Next ❯

Citations

Sep 25, 2019·Journal of Epidemiology·Li-Ping XieFang Liu
Jan 18, 2020·BMJ : British Medical Journal·Nicholas Beng Hui Ng, Rajeev Ramachandran
Dec 12, 2020·Archives of Disease in Childhood·Haruki TakikawaYosikazu Nakamura
Dec 12, 2020·Saudi Journal of Biological Sciences·Asad Aziz KhanHassib Narchi

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.