Kawasaki disease after burns

Abstract

Case 1 is an 11-month-old male infant who developed a high fever 7 days after suffering grade II burns on both lower extremities and the trunk caused by hot water. The results of laboratory examinations are shown in Table 1. Two days after the onset of high fever, he developed red, swollen and fissured lips, edema on his hands and feet and non-purulent conjunctivitis. Polymorphous erythema appeared on his extremities and trunk. Five days following the onset of the high fever, he was provided intravenous gamma-globulin therapy (IVG: 2 g/kg) and a nonsteroidal antiinflammatory drug (NSAID) based on the diagnosis of KD. The next day his fever and clinical signs resolved. Membranous desquamation of his fingertips and toes began to appear 5 days after the initiation of IVG therapy. Case 2 is a 1-year and 11-month-old male infant who developed a high fever 11 days after suffering a grade II burn injury on his left lower extremity caused by a hightemperature shower. He developed red, swollen and cracked lips, non-purulent conjunctivitis, edema on his hands and feet and a skin rash on his extremities and trunk on the following day. Results of the laboratory examinations are shown in Table 1. Five days following the onset of high fever, he was treated with IVG (2 g/kg) and NSAID. The next day, his fever and clinical signs resolved. Membranous desquamation of his hands and feet was subsequently observed. Case 3 is a two-year-old male child who developed a high fever 3 days after suffering grade II contact burns on both soles of his feet after walking on hot charcoal. Two days later he developed red, swollen and fissured lips, nonpurulent conjunctivitis, cervical lymph node enlargement and a skin rash on his extremities and trunk. Results of the laboratory examinations are shown in Table 1. He was treated only with NSAID. Three days later fever and other manifestations resolved. Desquamation of his fingertips was subsequently observed. None of these patients showed any apparent sign of infection on the burns nor had any cardiac involvement. In all three patients the bacterial cultures from the throat, blood, urine and scalds were all negative except for normal flora.