Clinicians should take caution when diagnosing a child who has a high fever and whose tests show evidence of adenovirus, and not assume the virus is responsible for Kawasaki-like symptoms. According to a new study from Nationwide Children's Hospital appearing in Clinical Infectious Diseases, adenovirus detection is not uncommon among children with Kawasaki disease.
Kawasaki disease is a rare but serious condition in children that involves inflammation of the blood vessels, specifically the heart vessels that supply the heart tissue or coronary arteries. It is the most common cause of pediatric acquired heart disease in the developed world. Children with Kawasaki disease or illness caused by adenoviruses often first present with a high and persistent fever. Early diagnosis for Kawasaki disease before the tenth day of fever is essential to prevent sequelae in the heart.
"Kawasaki disease and acute adenoviral infection can present with many of the same clinical characteristics," says Preeti Jaggi, MD, member of the Section of Infectious Diseases at Nationwide Children's and lead study author. "Given the similarities, human adenovirus infection is one of the most frequent conditions included on the differential diagnosis when considering Kawasaki disease." However, few data are available regarding the differences in frequency, viral load and types of detectable human adenovirus in Kawasaki disease patients and in children who have adenovirus disease that mimicks Kawasaki disease.
The study aimed to determine whether there are differences in the amount of human adenovirus in the upper airway in children with human adenovirus infection versus those diagnosed with Kawasaki disease. Dr. Jaggi and her team compared Kawasaki disease patients who were positive for human adenovirus infection with other patients diagnosed with human adenovirus infection during a two year period at Nationwide Children's. Among 77 Kawasaki disease patients, nearly 13 percent had human adenovirus detected.
"Evidence suggests that human adenovirus strains can persist in pediatric adenoids and tonsils and are capable of low level shedding. PCR analysis can detect non-replicating virus," says Dr. Jaggi, also assistant professor of Clinical Pediatrics at The Ohio State University College of Medicine. "This may explain why PCR, but not viral culture, could detect human adenovirus in these Kawasaki disease patients."
The findings indicate that detection of human adenovirus in a patient with suspected Kawasaki disease should be interpreted with caution. "Detection of human adenovirus in these patients is fairly common and does not exclude the diagnosis of Kawasaki disease," says Dr. Jaggi.
According to Dr. Jaggi, quantitative PCR, culture and human adenovirus typing methods may help distinguish human adenovirus disease mimicking Kawasaki disease from Kawasaki disease with accompanying human adenovirus detection.
Nationwide Children's Hospital: http://www.NationwideChildrens.org
This press release was posted to serve as a topic for discussion. Please comment below. We try our best to only post press releases that are associated with peer reviewed scientific literature. Critical discussions of the research are appreciated. If you need help finding a link to the original article, please contact us on twitter or via e-mail.
Arizona death row inmate Joseph Wood took almost 2 hours to die – why is a drug combination is being experimented with in the death chamber?
Scientists have discovered what may be the most common virus in people worldwide. The tiny critter doesn't make us sick but may be involved in obesity and diabetes.
Paracetamol, a painkiller universally recommended to treat people with acute low back pain, does not speed recovery or reduce pain from the condition, according to the results of a large trial published on Thursday.
Bone marrow grafts have helped both patients stay all but virus-free for three years. But the disease has come back before in others, and a simpler treatment is needed
Low levels of alcohol can improve your ability to discriminate between different odours, but be warned, the effect is reversed if you drink too much
Modified mozzies will be raised and released on a commercial scale for the first time, but critics warn that this biotech has not been sufficiently tested
Locally acquired cases of chikungunya virus have been identified in the US for the first time, while cases soar in Europe and Central America
A significant percentage of obese kids think their weight is just fine. But do they need to know the truth to get healthier?
Cancer-fighting drug romidepsin has been shown to expose hibernating HIV, making it susceptible to attack
Oversleep causes a feeling similar to feeling hung over and it's caused by the same biological function that gives you jet lag.