Key result
Kawasaki disease shock syndrome presented with more frequent echocardiographic abnormalities (P=0.022) and higher median platelet counts (312 vs 184.5 x 10³/μL) than toxic shock syndrome.
Why the study?
What are the early differentiating clinical, laboratory, and echocardiographic features between Kawasaki disease shock syndrome and toxic shock syndrome in pediatric intensive care patients?
Observational (n=33)
What are the early differentiating clinical, laboratory, and echocardiographic features between Kawasaki disease shock syndrome and toxic shock syndrome in pediatric intensive care patients?
p-value: p=0.022
Echocardiography, anemia, and thrombocytosis can help clinicians differentiate Kawasaki disease shock syndrome from toxic shock syndrome early in the pediatric intensive care setting.
Echocardiography and platelet counts may aid differentiation in pediatric shock; leaves open prospective validation before guiding practice.
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 × 10³ per μL (range, 116-518) vs. 184.5 × 10³ per μL (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.
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Lin et al. (2015) conducted an observational in Kawasaki disease shock syndrome and toxic shock syndrome (n=33). Kawasaki disease shock syndrome vs. Toxic shock syndrome was evaluated on Echocardiographic abnormalities (valvulitis or coronary artery lesions) (p=0.022). Kawasaki disease shock syndrome presented with more frequent echocardiographic abnormalities (P=0.022) and higher median platelet counts (312 vs 184.5 x 10³/μL) than toxic shock syndrome.
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