A 13-Year-Old Boy Who Has Kawasaki Disease Shock Syndrome Presents with ParotitisFunding This research received no specific grant from any funding agency or commercial or not-for-profit sectors.
13 May 2019
30 August 2019
09 October 2019 (online)
We report a 13-year-old boy who (initially) had symptoms of toxic shock-like syndrome and mumps. Then, the patient was hospitalized in the pediatric intensive care unit (PICU) because of his ongoing hemodynamic instability (low blood pressure of 70/30 mm Hg and capillary refill time of > 4 seconds). During his stay in the PICU, the patient was treated with fluid resuscitation and vasoactive infusion and at the same time was diagnosed with Kawasaki disease shock syndrome (KDSS), when giant right coronary artery aneurysms were detected on echocardiographic examination. This case illustrates the risk of KDSS in patient who carries both parotitis and toxic shock-like syndrome. The clinicians should be cautious about detecting any types of coronary artery aneurysms in such patients. This is the first case of KDSS associated with parotitis reported in the literature.
This case report does not contain any studies with human participants or animals performed by any of the authors. Institutional Review Board approval was not required for this case report.
All authors participated in creating the content of the case report, editing, and providing final approval for submission. No undisclosed authors contributed to the case report.
- 1 Barut K, Sahin S, Kasapcopur O. Pediatric vasculitis. Curr Opin Rheumatol 2016; 28 (01) 29-38
- 2 Newburger JW, Takahashi M, Gerber MA. , et al; Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease; Council on Cardiovascular Disease in the Young; American Heart Association; American Academy of Pediatrics. Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Circulation 2004; 110 (17) 2747-2771
- 3 Harwood-Nuss AL, Perry S. Toxic shock syndrome and toxic shock-like syndrome. In: Tintinalli JE, Ruiz E, Krome RL. , eds. Emergency Medicine, 4th ed. New York: McGraw-Hill; 1996: 697-701
- 4 Wolf JE, Rabinowitz LG. Streptococcal toxic shock-like syndrome. Arch Dermatol 1995; 131 (01) 73-77
- 5 Gamez-Gonzalez LB, Moribe-Quintero I, Cisneros-Castolo M. , et al. Kawasaki disease shock syndrome: unique and severe subtype of Kawasaki disease. Pediatr Int (Roma) 2018; 60 (09) 781-790
- 6 Dominguez SR, Friedman K, Seewald R, Anderson MS, Willis L, Glodé MP. Kawasaki disease in a pediatric intensive care unit: a case-control study. Pediatrics 2008; 122 (04) e786-e790
- 7 Yim D, Ramsay J, Kothari D, Burgner D. Coronary artery dilatation in toxic shock-like syndrome: the Kawasaki disease shock syndrome. Pediatr Cardiol 2010; 31 (08) 1232-1235
- 8 Gamillscheg A, Zobel G, Karpf EF. , et al. Atypical presentation of Kawasaki disease in an infant. Pediatr Cardiol 1993; 14 (04) 223-226
- 9 Li Y, Yang Q, Yu X, Qiao H. A case of Kawasaki disease presenting with parotitis: a case report and literature review. Medicine (Baltimore) 2019; 98 (22) e15817
- 10 Shulman ST, Rowley AH. Kawasaki disease: insights into pathogenesis and approaches to treatment. Nat Rev Rheumatol 2015; 11 (08) 475-482
- 11 Davies HD, Kirk V, Jadavji T, Kotzin BL. Simultaneous presentation of Kawasaki disease and toxic shock syndrome in an adolescent male. Pediatr Infect Dis J 1996; 15 (12) 1136-1138
- 12 Benseler SM, McCrindle BW, Silverman ED, Tyrrell PN, Wong J, Yeung RS. Infections and Kawasaki disease: implications for coronary artery outcome. Pediatrics 2005; 116 (06) e760-e766