Journal Article

Kawasaki Disease Presenting with Hemorrhagic Pleural Effusion

Susan D'Souza, Raju P. Khubchandani and Avinash K. Shetty

in Journal of Tropical Pediatrics

Volume 52, issue 4, pages 299-301
Published in print August 2006 | ISSN: 0142-6338
Published online September 2005 | e-ISSN: 1465-3664 | DOI: http://dx.doi.org/10.1093/tropej/fmh076
Kawasaki Disease Presenting with Hemorrhagic Pleural Effusion

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Hemorrhagic pleural effusion associated with Kawasaki disease (KD) is very rare and has not been reported in the medical literature. We describe a 5-year-old male with incomplete (atypical) KD who presented with fever and severe respiratory distress due to bilateral pleural effusions. Other features included unilateral cervical lymphadenopathy, swelling of the hands and feet followed by periungual desquamation, elevated erythrocyte sedimentation rate, thrombocytosis and sterile pyuria. Pleural fluid analysis revealed a hemorrhagic exudative effusion. Therapy with high-dose i.v. immunoglobulin resulted in dramatic clinical improvement and resolution of pleural effusion. An echocardiogram obtained at presentation and at 6 weeks of illness was normal. Pediatricians should be aware that hemorrhagic pleural effusion can be a presenting manifestation of KD.

Journal Article.  1626 words. 

Subjects: Paediatrics

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