This Article  • Full text  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (18)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Pediatrics, Other  • Alert me on articles by topic

Use of Clinical Features and a Rapid Direct Fluorescent Antigen Test

Stephen R. Barone, MD; Lucy R. Pontrelli, MD; Leonard R. Krilov, MD

Arch Pediatr Adolesc Med. 2000;154:453-456.

Objective  To compare the clinical and laboratory features of children with Kawasaki disease with those with acute adenoviral infection, which may mimic Kawasaki disease.

Design  We retrospectively compared the medical records of children with Kawasaki disease and atypical Kawasaki disease with those of children with acute adenoviral infection. All children included were initially evaluated because their primary care physicians were concerned that they might have Kawasaki disease. The utility of a rapid direct fluorescent antigen test for adenovirus was evaluated. Thirty-six children with Kawasaki disease (23 with classic and 13 with atypical presentations) and 7 patients with acute adenoviral infection were studied.

Setting  A tertiary care pediatric hospital.

Results  Children with Kawasaki disease were more likely to have conjuctivitis (36 of 36 vs 4 of 7), strawberry tongues (23 of 36 vs 1 of 7), perineal peeling (19 of 36 vs 0 of 7), and distal extremity changes (22 of 36 vs 0 of 7) than those with acute adenoviral infection. Children with acute adenoviral infection were more likely to have purulent conjuctivitis (3 of 7 vs 1 of 36) and exudative pharyngitis (3 of 7 vs 1 of 35). In addition to pyuria (13 of 26 vs 0 of 6), patients with Kawasaki disease had higher mean white blood cell counts (15.3 ± 3.5 vs 11.5 ± 6.0 x10⁹/L), erythrocyte sedimentation rates (56 vs 42 mm/h), platelet counts (426 vs 259 x 10⁹/L), and levels of alanine aminotransferase (101 vs 18 U/L) than those with acute adenoviral infection. Children with Kawasaki disease had lower mean albumin levels (32 vs 36 g/L). A rapid antigen test for adenovirus had a specificity and sensitivity of 100% compared with viral culture.

Conclusions  Kawasaki disease and acute adenoviral infection can present with many of the same clinical characteristics. A rapid direct fluorescent antigen assay for adenovirus may be a helpful adjunctive test for distinguishing acute adenoviral infection from Kawasaki disease.

From the Department of Pediatrics, North Shore University Hospital, New York University School of Medicine, Manhasset.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Prevalence of Coronary Artery Lesions on the Initial Echocardiogram in Kawasaki Syndrome
Baer et al.
Arch Pediatr Adolesc Med 2006;160:686-690.
ABSTRACT | FULL TEXT  

Adenovirus Infection in Hospitalized Immunocompetent Children
Peled et al.
CLIN PEDIATR 2004;43:223-229.
ABSTRACT  

Adenoviral Infections in Children: The Impact of Rapid Diagnosis
Rocholl et al.
Pediatrics 2004;113:e51-56.
ABSTRACT | FULL TEXT  

Kawasaki Disease in Very Young Infants: High Prevalence of Atypical Presentation and Coronary Arteritis
Genizi et al.
CLIN PEDIATR 2003;42:263-267.
 

Differentiation of Adenoviral Infection and Kawasaki Disease
Barton and Barone
Arch Pediatr Adolesc Med 2001;155:96-97.
FULL TEXT  

Differentiating Adenoviral Infection from Kawasaki Disease
JWatch General 2000;2000:8-8.
FULL TEXT  

Perineal and Periungual Peeling: Think Kawasaki
Journal Watch Dermatology 2000;2000:4-4.
FULL TEXT