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Kawasaki disease manifesting as bilateral facial nerve palsy and meningitis: a case report and literature review

BACKGROUND: Kawasaki disease (KD) is an acute multisystem vasculitic syndrome that predominantly affects infants and young children. Neurological complications are rare in patients with KD and the diagnosis is challenging. We report a case of KD that manifested as bilateral facial nerve palsy and me...

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Autores principales: Zhang, Bo, Hao, Yunpeng, Zhang, Yanfeng, Yang, Nuo, Li, Hang, Liang, Jianmin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6726819/
https://www.ncbi.nlm.nih.gov/pubmed/31364426
http://dx.doi.org/10.1177/0300060519854287
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author Zhang, Bo
Hao, Yunpeng
Zhang, Yanfeng
Yang, Nuo
Li, Hang
Liang, Jianmin
author_facet Zhang, Bo
Hao, Yunpeng
Zhang, Yanfeng
Yang, Nuo
Li, Hang
Liang, Jianmin
author_sort Zhang, Bo
collection PubMed
description BACKGROUND: Kawasaki disease (KD) is an acute multisystem vasculitic syndrome that predominantly affects infants and young children. Neurological complications are rare in patients with KD and the diagnosis is challenging. We report a case of KD that manifested as bilateral facial nerve palsy and meningitis. CASE REPORT: A 6-month-old boy presented with a 10-day history of fever. Four days before admission, the patient developed a rash, conjunctival injection, perioral and perianal excoriation, and bilateral facial nerve palsy. Brain magnetic resonance imaging was normal. Echocardiography showed dilated coronary arteries and coronary artery aneurysms. A cerebrospinal fluid examination showed an elevated leukocyte count. A diagnosis of KD was made, and the patient was treated with gamma globulin and aspirin. The patient’s fever subsided on the following day and the right-sided facial nerve palsy was relieved 1 month later. An 18-month follow-up showed that the left-sided facial nerve palsy persisted and the patient’s condition remained stable. CONCLUSION: KD manifesting as bilateral facial nerve palsy and meningitis is extremely rare. Clinicians should be aware of this condition, and early diagnosis and appropriate treatment should be emphasized.
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spelling pubmed-67268192019-09-13 Kawasaki disease manifesting as bilateral facial nerve palsy and meningitis: a case report and literature review Zhang, Bo Hao, Yunpeng Zhang, Yanfeng Yang, Nuo Li, Hang Liang, Jianmin J Int Med Res Case Report and Case Series BACKGROUND: Kawasaki disease (KD) is an acute multisystem vasculitic syndrome that predominantly affects infants and young children. Neurological complications are rare in patients with KD and the diagnosis is challenging. We report a case of KD that manifested as bilateral facial nerve palsy and meningitis. CASE REPORT: A 6-month-old boy presented with a 10-day history of fever. Four days before admission, the patient developed a rash, conjunctival injection, perioral and perianal excoriation, and bilateral facial nerve palsy. Brain magnetic resonance imaging was normal. Echocardiography showed dilated coronary arteries and coronary artery aneurysms. A cerebrospinal fluid examination showed an elevated leukocyte count. A diagnosis of KD was made, and the patient was treated with gamma globulin and aspirin. The patient’s fever subsided on the following day and the right-sided facial nerve palsy was relieved 1 month later. An 18-month follow-up showed that the left-sided facial nerve palsy persisted and the patient’s condition remained stable. CONCLUSION: KD manifesting as bilateral facial nerve palsy and meningitis is extremely rare. Clinicians should be aware of this condition, and early diagnosis and appropriate treatment should be emphasized. SAGE Publications 2019-07-31 2019-08 /pmc/articles/PMC6726819/ /pubmed/31364426 http://dx.doi.org/10.1177/0300060519854287 Text en © The Author(s) 2019 http://creativecommons.org/licenses/by-nc/4.0/ Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Case Report and Case Series
Zhang, Bo
Hao, Yunpeng
Zhang, Yanfeng
Yang, Nuo
Li, Hang
Liang, Jianmin
Kawasaki disease manifesting as bilateral facial nerve palsy and meningitis: a case report and literature review
title Kawasaki disease manifesting as bilateral facial nerve palsy and meningitis: a case report and literature review
title_full Kawasaki disease manifesting as bilateral facial nerve palsy and meningitis: a case report and literature review
title_fullStr Kawasaki disease manifesting as bilateral facial nerve palsy and meningitis: a case report and literature review
title_full_unstemmed Kawasaki disease manifesting as bilateral facial nerve palsy and meningitis: a case report and literature review
title_short Kawasaki disease manifesting as bilateral facial nerve palsy and meningitis: a case report and literature review
title_sort kawasaki disease manifesting as bilateral facial nerve palsy and meningitis: a case report and literature review
topic Case Report and Case Series
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6726819/
https://www.ncbi.nlm.nih.gov/pubmed/31364426
http://dx.doi.org/10.1177/0300060519854287
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