Pediatric Kawasaki Disease And Adult Human Immunodeficiency Virus Kawasaki-like Syndrome Are Likely The Same Malady
OPEN FORUM INFECTIOUS DISEASES
Johnson RM, Bergmann KR, Manaloor JJ, Yu X, Slaven JE and Kharbanda AB.
J Infect. 2007 Dec;55(6):488-94.
Kawasaki-like syndrome (KLS) is rare in adults; one third of these patients are infected by Human immunodeficiency virus (HIV). Our study reports cases of KLS occurring in HIV-positive adults and reviews the literature to compare their characteristics with HIV-negative adults and children with Kawasaki disease (KD).
Report of cases and review of the literature.
Amongst 20 cases reviewed, including 4 who were managed at our institution, KLS was associated with severe immunosuppression and a high HIV viral load. There was frequent co-infection by hepatitis viruses. Desquamation and liver abnormalities were more frequent in HIV-negative adults whereas headaches and gastrointestinal disorders more common in HIV-positive adults. Intravenous immunoglobulin was effective therapy. Relapse was more frequent among HIV-positive patients. No cardiovascular complications or deaths occurred.
Advanced immunosuppression due to HIV may predispose to KLS. The differential diagnosis that must be considered includes drug hypersensitivity reactions and staphylococcal infections.