Scrotal and penile edema in a patient with incomplete kawasaki disease: a case report and brief literature review.
Kawasaki disease
Penile edema
Scrotal edema
Journal
BMC pediatrics
ISSN: 1471-2431
Titre abrégé: BMC Pediatr
Pays: England
ID NLM: 100967804
Informations de publication
Date de publication:
09 Oct 2024
09 Oct 2024
Historique:
received:
15
08
2023
accepted:
23
09
2024
medline:
10
10
2024
pubmed:
10
10
2024
entrez:
9
10
2024
Statut:
epublish
Résumé
Kawasaki disease (KD) is a medium artery vasculitis that predominantly affects children under age 5. Prompt diagnosis and treatment with IVIG and moderate dose aspirin is required to prevent the formation of coronary artery aneurysms. While scrotal edema and erythema have been seen in KD, here we present a distinctive case of incomplete Kawasaki with these features as well as penile edema. A 2-year-old, unvaccinated, African American male presented with 4 days of fever, bilateral limbic sparing conjunctivitis, a papular rash, unilateral shotty cervical lymphadenopathy, mild right-hand edema, and scrotal and penile edema and erythema. His labs were significant for sterile pyuria, elevated ALT, anemia for age, and hypoalbuminemia. He was diagnosed with incomplete Kawasaki disease and was treated with IVIG and moderate dose aspirin. Echocardiogram was negative for coronary aneurysms. His symptoms resolved and he was discharged home with low dose aspirin. At his 2-week follow up, he remained well-appearing with no refractory Kawasaki symptoms. This is a unique case of penile edema in KD which to our knowledge has not been previously reported in literature. An understanding of genitourinary symptoms in Kawasaki disease can help timely diagnosis and treatment of the disease.
Sections du résumé
BACKGROUND
BACKGROUND
Kawasaki disease (KD) is a medium artery vasculitis that predominantly affects children under age 5. Prompt diagnosis and treatment with IVIG and moderate dose aspirin is required to prevent the formation of coronary artery aneurysms. While scrotal edema and erythema have been seen in KD, here we present a distinctive case of incomplete Kawasaki with these features as well as penile edema.
CASE PRESENTATION
METHODS
A 2-year-old, unvaccinated, African American male presented with 4 days of fever, bilateral limbic sparing conjunctivitis, a papular rash, unilateral shotty cervical lymphadenopathy, mild right-hand edema, and scrotal and penile edema and erythema. His labs were significant for sterile pyuria, elevated ALT, anemia for age, and hypoalbuminemia. He was diagnosed with incomplete Kawasaki disease and was treated with IVIG and moderate dose aspirin. Echocardiogram was negative for coronary aneurysms. His symptoms resolved and he was discharged home with low dose aspirin. At his 2-week follow up, he remained well-appearing with no refractory Kawasaki symptoms.
CONCLUSION
CONCLUSIONS
This is a unique case of penile edema in KD which to our knowledge has not been previously reported in literature. An understanding of genitourinary symptoms in Kawasaki disease can help timely diagnosis and treatment of the disease.
Identifiants
pubmed: 39385164
doi: 10.1186/s12887-024-05099-x
pii: 10.1186/s12887-024-05099-x
doi:
Substances chimiques
Aspirin
R16CO5Y76E
Immunoglobulins, Intravenous
0
Types de publication
Journal Article
Case Reports
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
640Informations de copyright
© 2024. The Author(s).
Références
Saguil A, Fargo M, Grogan S. Diagnosis and management of kawasaki disease. Am Fam Physician. 2015;91(6):365–71.
pubmed: 25822554
Sundel R. Kawasaki Disease: clinical features and diagnosis. In: Klein-Gitelman M, Kaplan S, TePas E, editors. UpToDate. Waltham, MA: Wolters Kluwer; 2023.
Tripathy S, Aggarwal B, Mandal A, Bagri N. Atypical Kawasaki disease: diagnosis underneath diapers. J Postgrad Med. 2018;64(3):190.
doi: 10.4103/jpgm.JPGM_201_18
pubmed: 29992915
pmcid: 6066622
Jibiki T, Sakai T, Saitou T, Kanazawa M, Ide T, Fujita M, et al. Acute scrotum in Kawasaki disease: two case reports and a literature review. Pediatr Int. 2013;55(6):771–5.
doi: 10.1111/ped.12112
pubmed: 24330284
Ha TS, Lee JS. Scrotal involvement in childhood Henoch-Schönlein purpura. Acta Paediatr. 2007;96(4):552–5.
doi: 10.1111/j.1651-2227.2006.00173.x
pubmed: 17306010
Güneş M, Kaya C, Koca O, Keles MO, Karaman MI. Acute scrotum in Henoch-Schönlein purpura: fact or fiction? Turk J Pediatr. 2012;54(2):194–7.
pubmed: 22734311
Diana A, Gaze H, Laubscher B, de Meuron G, Tschantz P. A case of pediatric Henoch-Schönlein purpura and thrombosis of spermatic veins. J Pediatr Surg. 2000;35(12):1843.
doi: 10.1053/jpsu.2000.9293
pubmed: 11101753
Kaya Akca U, Batu ED, Serin O, Ipek OF, Aydin O, Teksam O, et al. Penile involvement of immunoglobulin a vasculitis/Henoch-Schönlein purpura. J Pediatr Urol. 2021;17(3):409.e1-409.e8.
doi: 10.1016/j.jpurol.2021.01.012
Straface E, Marchesi A, Gambardella L, Metere A, Tarissi de Jacobis I, Viora M, et al. Does oxidative stress play a critical role in Cardiovascular complications of Kawasaki Disease? Antioxid Redox Signal. 2012;17(10):1441–6.
doi: 10.1089/ars.2012.4660
pubmed: 22578402
Kusuda T, Nakashima Y, Murata K, Kanno S, Nishio H, Saito M, et al. Kawasaki Disease-Specific Molecules in the Sera are linked to Microbe-Associated molecular patterns in the biofilms. PLoS ONE. 2014;9(11):e113054.
doi: 10.1371/journal.pone.0113054
pubmed: 25411968
pmcid: 4239021