Discrimination of Kawasaki disease with concomitant adenoviral detection differentiating from isolated adenoviral infection

Kim, Jong Han; Kang, Hye Ree; Kim, Su Yeong; Ban, Ji-Eun

Various studies have been carried out to find out the etiology of Kawasaki disease (KD). Viral infection is thought to be one of the causes of KD, but it is still controversial [1] [2] [3] [4] . Although several potential viral causes of KD are identified, the diagnosis of KD with concomitant viral infection is a little unclear to confirm KD. Adenoviral infection is frequently involved in young children less than 3 years and is characterized with prolonged high fever, upper and lower respiratory tract symptom, conjunctivitis and gastrointestinal symptom with hepatic involvement. Inflammatory biomarker such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels are mostly ele vated in patients with adenoviral infection. Because of strong inflammatory response, adeno viral infection closely resembles bacterial infection and KD [5] [6] [7] [8] . Although the majority patients of adenoviral infection presented respiratory condition, extrapulmonary manifestation of conjunctivitis, skin rash, mucous membrane changes, cervical lymphadenopathy and encephalitis can be associated. The various clinical manifestation of adenovirus infections are particularly similar to KD regarding the clinical aspects [9] [10] [11] [12] [13] .