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Case Report
Leptospirosis Associated Kawasaki Disease. Differential Diagnosis or Disease Association? Case Report and Review of The Literature.
Mohammed Nashawi
Olga-Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0001-7580-2655
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Kawasaki disease (KD) is a systemic vasculitis which affects medium-sized arteries. Although diagnostic and classification criteria exist, differentiation from other diseases can be difficult.
Case Presentation: We present a 3-year old patient with a diagnosis of complete KD with positivity for urine-PCR on leptospirosis.
In our patient conjunctivitis, rash, fever, cervical lymphadenopathy, palmar swelling, exanthema were seen, indicating all criteria for complete KD. After 2 weeks periungual desquamation developed. Besides this patient two further cases were retrieved form the literature with similar clinical courses indicating leptospirosis associated KD.
Conclusion: These cases indicate that leptospirosis may not only mimic but also be associated with KD shown by specific findings like desquamation of fingers, toes and oropharyngeal mucous membrane changes. To distinguish between KD, leptospirosis and leptospirosis associated KD a proper history taking including travel history and contact to animals is fundamental as well as thorough clinical and cardiac examinations in the course of the disease. While diagnostic procedures and observation might take time, treatment of acute KD should not be delayed.
Keywords
Kawasaki Disease, Leptospirosis, Desquamation of Finger, Proteinuria.
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CURRENT STATUS: Under Review
Version 1
Posted 28 Sep, 2020
No community comments so far
Review #1 received
Received 22 Dec, 2020
Review #2 received
Received 15 Dec, 2020
Reviewer #2 agreed
On 12 Dec, 2020
Reviewer #1 agreed
On 09 Dec, 2020
Reviewers invited
Invitations sent on 08 Dec, 2020
First submitted
On 22 Sep, 2020
Editor assigned
On 22 Sep, 2020
Submission checks complete
On 21 Sep, 2020
Editor invited
On 21 Sep, 2020
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This preprint is under consideration at Pediatric Rheumatology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Case Report
Leptospirosis Associated Kawasaki Disease. Differential Diagnosis or Disease Association? Case Report and Review of The Literature.
Mohammed Nashawi
Olga-Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0001-7580-2655
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 28 Sep, 2020
No community comments so far
Review #1 received
Received 22 Dec, 2020
Review #2 received
Received 15 Dec, 2020
Reviewer #2 agreed
On 12 Dec, 2020
Reviewer #1 agreed
On 09 Dec, 2020
Reviewers invited
Invitations sent on 08 Dec, 2020
First submitted
On 22 Sep, 2020
Editor assigned
On 22 Sep, 2020
Submission checks complete
On 21 Sep, 2020
Editor invited
On 21 Sep, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Kawasaki disease (KD) is a systemic vasculitis which affects medium-sized arteries. Although diagnostic and classification criteria exist, differentiation from other diseases can be difficult.
Case Presentation: We present a 3-year old patient with a diagnosis of complete KD with positivity for urine-PCR on leptospirosis.
In our patient conjunctivitis, rash, fever, cervical lymphadenopathy, palmar swelling, exanthema were seen, indicating all criteria for complete KD. After 2 weeks periungual desquamation developed. Besides this patient two further cases were retrieved form the literature with similar clinical courses indicating leptospirosis associated KD.
Conclusion: These cases indicate that leptospirosis may not only mimic but also be associated with KD shown by specific findings like desquamation of fingers, toes and oropharyngeal mucous membrane changes. To distinguish between KD, leptospirosis and leptospirosis associated KD a proper history taking including travel history and contact to animals is fundamental as well as thorough clinical and cardiac examinations in the course of the disease. While diagnostic procedures and observation might take time, treatment of acute KD should not be delayed.
Figure 1
Figure 2