TY - JOUR
T1 - Case Report: Kawasaki Shock Syndrome With Polycyclic Eruption: A Peculiar Brain Imaging
AU - Masiello, Enrico
AU - Buonsenso, Danilo
AU - Lazzareschi, Ilaria
AU - Gatto, Antonio
AU - Piastra, Marco
AU - Chiaretti, Antonio
AU - Valentini, Piero
PY - 2021
Y1 - 2021
N2 - Kawasaki disease (KD) is a childhood vasculitis of unknown etiology. The present study describes a case of KD shock syndrome that occurred in an infant (age, 16 months) following 7 days of high fever and persistent rash characterized by target-like and purpuric skin lesions. The child developed neurological manifestations such as altered consciousness and irritability. Consequently, brain magnetic resonance imaging (MRI) was performed, revealing an inflammatory involvement of the anterior perforated substance and the hypothalamus. Cerebral involvement on brain MRI is rarely described in KD but when reported is characterized mostly by cerebral vasculitis. We illustrate for the first time in KD an inflammation in the brain not related to vasculitis, reporting peculiar neuroradiological findings. This last aspect has fascinated us in light of recent evidence about the immunological spectrum of Multisystem Inflammatory Syndrome in Children (MIS-C) and Kawasaki-like syndrome in the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) outbreak.
AB - Kawasaki disease (KD) is a childhood vasculitis of unknown etiology. The present study describes a case of KD shock syndrome that occurred in an infant (age, 16 months) following 7 days of high fever and persistent rash characterized by target-like and purpuric skin lesions. The child developed neurological manifestations such as altered consciousness and irritability. Consequently, brain magnetic resonance imaging (MRI) was performed, revealing an inflammatory involvement of the anterior perforated substance and the hypothalamus. Cerebral involvement on brain MRI is rarely described in KD but when reported is characterized mostly by cerebral vasculitis. We illustrate for the first time in KD an inflammation in the brain not related to vasculitis, reporting peculiar neuroradiological findings. This last aspect has fascinated us in light of recent evidence about the immunological spectrum of Multisystem Inflammatory Syndrome in Children (MIS-C) and Kawasaki-like syndrome in the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) outbreak.
KW - CNS inflammation in Kawasaki disease shock syndrome
KW - CNS involvement in Kawasaki disease
KW - Kawasaki disease
KW - Kawasaki disease shock syndrome
KW - MISC
KW - CNS inflammation in Kawasaki disease shock syndrome
KW - CNS involvement in Kawasaki disease
KW - Kawasaki disease
KW - Kawasaki disease shock syndrome
KW - MISC
UR - http://hdl.handle.net/10807/214245
U2 - 10.3389/fped.2021.651457
DO - 10.3389/fped.2021.651457
M3 - Article
SN - 2296-2360
VL - 9
SP - 1
EP - 5
JO - Frontiers in Pediatrics
JF - Frontiers in Pediatrics
ER -