Pediatr Infect Vaccine.
2023 Dec;30(3):139-144. 10.14776/piv.2023.30.e23.
Diagnostic Conundrum: Fever and Pyuria Preceding Diagnosis of Kawasaki Disease in Children
- Affiliations
-
- 1Department of Pediatrics, Korea University Anam Hospital, Seoul, the Republic of Korea
- 2Department of Preventive Medicine, Korea University College of Medicine, Seoul, the Republic of Korea
- 3Department of Pediatrics, Korea University Ansan Hospital and Korea University College of Medicine, Seoul, the Republic of Korea
- KMID: 2551463
- DOI: http://doi.org/10.14776/piv.2023.30.e23
Abstract
- Purpose
Children with incomplete Kawasaki disease (KD) and pyuria may be misdiagnosed with urinary tract infection (UTI) during the early phase of the prodrome. We investigated the percentage of UTI diagnoses preceding a KD diagnosis.
Methods
Using the National Health Insurance data of South Korea, we assessed differences in UTI diagnoses made during the week preceding a KD diagnosis, according to demographic and geographic factors from November 2007–October 2019.
Results
A total of 53,822 KD cases were identified, including 304 patients (0.56%) diagnosed with a UTI during the week preceding a KD diagnosis. The younger age group (0–11 months) showed the highest percentage of preceding UTI diagnoses (0.95%), with higher odds than 4-year-old children (3.12; 95% confidence interval, 2.05–4.77).
Conclusions
These findings suggest a potentially misleading presentation of incomplete KD, a clinical conundrum requiring further investigation and validation, particularly in infants.
