title: Initial characteristics of Kawasaki disease with cerebrospinal fluid pleocytosis in febrile infants.
abstract: To distinguish between febrile infants with cerebrospinal fluid pleocytosis who are finally diagnosed with Kawasaki disease and those with enterovirus meningitis poses a diagnostic challenge. We compared clinical and laboratory features at admission between two groups of infants, aged 30-90 days, to identify markers of Kawasaki disease that initially presented as cerebrospinal fluid pleocytosis. During a 2-year period, 100 patients exhibiting cerebrospinal fluid pleocytosis were studied, including six (6.0%) with Kawasaki disease and 30 (30.0%) with enterovirus meningitis. A longer duration of fever before admission (P < 0.01), higher absolute neutrophil count (P < 0.01), increased C-reactive protein level (P < 0.01), pyuria (P = 0.02), and less prominent cerebrospinal fluid pleocytosis (P = 0.01) were identified as initial features of infants finally diagnosed with Kawasaki disease. No significant differences were evident in white blood cell count; platelet count; levels of hemoglobin, alanine aminotransaminase, aspartate aminotransferase, albumin, and sodium; cerebrospinal fluid chemistry; or presence of a rash. Our observations may offer early indicators of Kawasaki disease for timely diagnoses in febrile infants with cerebrospinal fluid pleocytosis.
authors.affiliation: Department of Pediatrics, Gyeongsang Institute of Health Science, National University School of Medicine, Jinju, Gyeongnam, South Korea.
authors.forename: Jung Sook
authors.initials: JS
authors.lastname: Yeom
authors.forename: Ji Sook
authors.initials: JS
authors.lastname: Park
authors.forename: Ji-Hyun
authors.initials: JH
authors.lastname: Seo
authors.forename: Eun Sil
authors.initials: ES
authors.lastname: Park
authors.forename: Jae-Young
authors.initials: JY
authors.lastname: Lim
authors.forename: Chan-Hoo
authors.initials: CH
authors.lastname: Park
authors.forename: Hyang Ok
authors.initials: HO
authors.lastname: Woo
authors.forename: Hee-Shang
authors.initials: HS
authors.lastname: Youn
mesh_terms: D002097:C-Reactive Protein / Q000032:analysis; D003937:Diagnosis, Differential; D004769:Enterovirus Infections / Q000134:cerebrospinal fluid / Q000175:diagnosis; D005076:Exanthema / Q000209:etiology; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007958:Leukocyte Count; D007964:Leukocytosis / Q000209:etiology*; D008297:Male; D008587:Meningitis, Viral / Q000134:cerebrospinal fluid / Q000175:diagnosis; D009080:Mucocutaneous Lymph Node Syndrome / Q000097:blood / Q000134:cerebrospinal fluid / Q000175:diagnosis*; D009504:Neutrophils; D011776:Pyuria / Q000209:etiology; D063189:Symptom Assessment
chemical_list: D002097:C-Reactive Protein