ArticleBMC pediatrics2018
Early features of Kawasaki disease with pyuria in febrile infants younger than 6 months.
Article in BMC pediatrics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed, 7 citations in OpenAlex.
- Unusual Manifestations of Kawasaki Disease in the COVID Era: A Case Series and Review of the Literature.Cureus · 2023Article
- Characteristics and Indications of Kawasaki Disease Among Infants Under 6 Months.Frontiers in pediatrics · 2020Article
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundChildren with Kawasaki disease (KD) and pyuria have been misdiagnosed with urinary tract infection (UTI). We compared clinical and laboratory features at admission between two groups of infants under 6 months of age who showed initial pyuria, to identify the initial clues suggestive of KD.
methodsWe retrospectively reviewed the medical records of children with fever who were under 6 months of age with pyuria, over a 10-year period (2007-2017). We included infants with sterile pyuria who were finally diagnosed with KD and those with UTI.
resultsDuring the period investigated, 12 (9.9%) KD patients with sterile pyuria and 378 infants with UTI were included in this study. Older age (P < 0.01), a longer duration of fever; total and before admission (P < 0.01), more negative nitrite test (P < 0.01), higher platelet count (P = 0.04), increased C-reactive protein (CRP) (P < 0.01) and erythrocyte sedimentation rate (ESR) (P < 0.01), were identified as initial features of infants finally diagnosed with KD. In the receiver operating characteristic analysis, optimal cut-off values of 509 k/μL for platelet count, 60 mg/L for CRP, and 68 mm/H for ESR were selected. Patients with ESR > 68 mm/hr had a ninefold higher odds of KD compared to those with lower ESR levels (odds ratio: 8.963, 95% confidence intervals: 1.936-41.493, P = 0.005), whereas CRP and platelet count could not significantly increase in the odds of KD at a cut-off point.
conclusionPersistent fever, elevated ESR, and negative urine nitrite test can serve as early clues to suspect KD in febrile infants with pyuria.
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