title: Reaction at the bacillus Calmette--Guérin inoculation site in patients with Kawasaki disease.
abstract: BACKGROUND
  The bacillus Calmette-Guérin (BCG) reaction is not included in the classical clinical criteria for Kawasaki disease (KD). However, a reaction at the BCG inoculation site has been mentioned among the "other clinical findings" that are present in about 30-50% of KD patients. The objective of this study was to investigate the clinical characteristics of KD patients with reactions at the BCG inoculation site.
  
  
  METHODS
  A retrospective study of all patients diagnosed with KD between September 2000 and August 2010 was performed. The clinical presentations, laboratory results, treatment outcomes, and coronary artery abnormalities in the BCG-reactive [BCG(+)] and BCG-nonreactive [BCG(-)] groups were analyzed and compared.
  
  
  RESULTS
  In total, 145 patients with KD diagnosed at our institution were included; 46 (31.7%) had a reaction at the BCG inoculation site. The BCG(+) group was younger than the BCG(-) group. Laboratory results showed higher white blood cell counts, platelet counts, and serum potassium levels, and lower low-density lipoprotein levels in the BCG(+) group. The BCG(+) group had a shorter fever duration before intravenous immunoglobulin treatment and a shorter total fever duration than the BCG(-) group. Multivariable logistic regression analysis showed that the age at diagnosis was the only factor significantly associated with a reaction at the BCG inoculation site in KD patients.
  
  
  CONCLUSIONS
  In countries with a national BCG vaccination program, a reaction at the BCG inoculation site could be a useful and early diagnostic sign of KD among younger patients, especially those younger than 6 months.
authors: Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
authors: Chi-Chieh
authors: CC
authors: Lai
authors: Pi-Chang
authors: PC
authors: Lee
authors: Chih-Chien
authors: CC
authors: Wang
authors: Be-Tau
authors: BT
authors: Hwang
authors: C C Laura
authors: CC
authors: Meng
authors: Ming-Chih
authors: MC
authors: Tsai
mesh_terms: D000367:Age Factors; D001500:BCG Vaccine / Q000276:immunology*; D002675:Child, Preschool; D003324:Coronary Artery Disease / Q000209:etiology; D005260:Female; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications* / Q000175:diagnosis; D012189:Retrospective Studies; D014611:Vaccination
chemical_list: D001500:BCG Vaccine