PMID- 26222065
OWN - NLM
STAT- MEDLINE
DCOM- 20160714
LR  - 20151013
IS  - 1532-0987 (Electronic)
IS  - 0891-3668 (Linking)
VI  - 34
IP  - 11
DP  - 2015 Nov
TI  - Early Differentiation of Kawasaki Disease Shock Syndrome and Toxic Shock Syndrome 
      in a Pediatric Intensive Care Unit.
PG  - 1163-7
LID - 10.1097/INF.0000000000000852 [doi]
AB  - BACKGROUND: Kawasaki disease shock syndrome (KDSS) and toxic shock syndrome (TSS) 
      can present as shock and fever with skin rash, but the management of these 2 
      groups of patients is different. This report proposes to help clinicians earlier 
      distinguish these 2 diseases and expedite institution of appropriate therapy. 
      METHODS: We retrospectively reviewed the medical records of patients admitted to 
      the pediatric intensive care unit with the diagnosis of KDSS or TSS from January 
      2000 through December 2010. Clinical, laboratory and echocardiographic data were 
      collected for analysis of differences between them. RESULTS: Seventeen patients 
      met the inclusion criteria of KDSS and 16 had a confirmed diagnosis of TSS. The 
      mean age of the KDSS group was significantly younger than that of the TSS group 
      (36.8 +/- 41.1 vs. 113.3 +/- 55.6 months, P < 0.001). Significantly lower 
      hemoglobulin and age-adjusted hemoglobulin concentrations were noted in the KDSS 
      group [Hb, age-adjusted Z score, -1.88 (range, -3.9 to 3.9) vs. 0.89 (range, -6.4 
      to 10.8), P = 0.006]. The median platelet count of the KDSS group was nearly 
      twice that of the TSS group [312 x 10(3) per muL (range, 116-518) vs. 184.5 x 10(3) 
      per muL (range: 31-629), P = 0.021]. Echocardiographic abnormalities, such as 
      valvulitis (mitral or tricuspid regurgitation) and coronary artery lesions, were 
      significantly more common in the KDSS group (P = 0.022). CONCLUSIONS: 
      Echocardiography, anemia and thrombocytosis are useful early differentiating 
      features between KDSS and TSS patients.
FAU - Lin, Ying-Jui
AU  - Lin YJ
AD  - From the Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and 
      Chang Gung University, College of Medicine, Taiwan.
FAU - Cheng, Ming-Chou
AU  - Cheng MC
FAU - Lo, Mao-Hung
AU  - Lo MH
FAU - Chien, Shao-Ju
AU  - Chien SJ
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Pediatr Infect Dis J
JT  - The Pediatric infectious disease journal
JID - 8701858
SB  - IM
MH  - Adolescent
MH  - Anemia
MH  - Child
MH  - Child, Preschool
MH  - Diagnosis, Differential
MH  - Echocardiography
MH  - Female
MH  - Humans
MH  - Infant
MH  - Intensive Care Units, Pediatric
MH  - Male
MH  - Mucocutaneous Lymph Node Syndrome/*diagnosis/epidemiology/*physiopathology
MH  - Retrospective Studies
MH  - Shock, Septic/*diagnosis/epidemiology/*physiopathology
MH  - Thrombocytosis
EDAT- 2015/07/30 06:00
MHDA- 2016/07/15 06:00
CRDT- 2015/07/30 06:00
PHST- 2015/07/30 06:00 [entrez]
PHST- 2015/07/30 06:00 [pubmed]
PHST- 2016/07/15 06:00 [medline]
AID - 10.1097/INF.0000000000000852 [doi]
PST - ppublish
SO  - Pediatr Infect Dis J. 2015 Nov;34(11):1163-7. doi: 10.1097/INF.0000000000000852.