Coronary artery dilation in children with febrile illnesses other than Kawasaki disease: A case report and literature review

Background: Coronary artery dilation (CAD) had rarely been described as a cardiac complication of febrile disease other than Kawasaki disease (KD). There are rare cases complicated by CAD reported in patients with Mycoplasma pneumoniae (MP) infection. Case presentation: A 6-year-old boy with severe...

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Main Authors: Yafei Guo, Lixia Yang, Shuran Shao, Nanjun Zhang, Yimin Hua, Kaiyu Zhou, Fan Ma, Xiaoliang Liu
Format: Article
Language:English
Published: Elsevier 2023-11-01
Series:Heliyon
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2405844023085936
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author Yafei Guo
Lixia Yang
Shuran Shao
Nanjun Zhang
Yimin Hua
Kaiyu Zhou
Fan Ma
Xiaoliang Liu
author_facet Yafei Guo
Lixia Yang
Shuran Shao
Nanjun Zhang
Yimin Hua
Kaiyu Zhou
Fan Ma
Xiaoliang Liu
author_sort Yafei Guo
collection DOAJ
description Background: Coronary artery dilation (CAD) had rarely been described as a cardiac complication of febrile disease other than Kawasaki disease (KD). There are rare cases complicated by CAD reported in patients with Mycoplasma pneumoniae (MP) infection. Case presentation: A 6-year-old boy with severe Mycoplasma pneumoniae pneumonia (MPP) was transferred to our hospital due to significant respiratory distress on the 11th day from disease onset. Nadroparin, levofloxacin, and methylprednisolone followed by oral prednisone were aggressively prescribed. His clinical condition gradually achieved remission, and the drugs were withdrawn on the 27th day. Regrettably, the recurrent fever attacked him again in the absence of infection-toxic manifestations. Necrotizing pneumonia (NP) was found on chest CT. And echocardiography revealed right CAD (diameter, 3.40mm; z-score, 3.8), however, his clinical and laboratory findings did not meet the diagnostic criteria of KD. CAD was proposed to result from MP infection, and aspirin was prescribed. Encouragingly, the CAD regressed one week later (diameter, 2.50mm; z-score, 1.4). Additionally, the child defervesced seven days after the initiation of prednisone and Nadroparin treatment. The patient was ultimately discharged home on the 50th day. During follow-up, the child was uneventful with normal echocardiography and fully resolved chest CT lung lesions. Conclusions: CAD can develop in patients with severe MP infection. Pediatricians should be alert to the possibility of CAD in patients with severe MP infection and recognize that CAD might also develop in febrile disease rather than KD.
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spelling doaj.art-78973391f160402689fc65fbea87721e2023-12-02T07:02:04ZengElsevierHeliyon2405-84402023-11-01911e21385Coronary artery dilation in children with febrile illnesses other than Kawasaki disease: A case report and literature reviewYafei Guo0Lixia Yang1Shuran Shao2Nanjun Zhang3Yimin Hua4Kaiyu Zhou5Fan Ma6Xiaoliang Liu7Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education Chengdu, Sichuan, China; Key Laboratory of Development and Diseases of Women and Children of Sichuan Province, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education Chengdu, Sichuan, China; Key Laboratory of Development and Diseases of Women and Children of Sichuan Province, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China; West China Medical School of Sichuan University, Chengdu, Sichuan, ChinaDepartment of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China; West China Medical School of Sichuan University, Chengdu, Sichuan, ChinaDepartment of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China; The Cardiac development and early intervention unit, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education Chengdu, Sichuan, China; Key Laboratory of Development and Diseases of Women and Children of Sichuan Province, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China; The Cardiac development and early intervention unit, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education Chengdu, Sichuan, China; Key Laboratory of Development and Diseases of Women and Children of Sichuan Province, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China; The Cardiac development and early intervention unit, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education Chengdu, Sichuan, China; Key Laboratory of Development and Diseases of Women and Children of Sichuan Province, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China; Corresponding author. Dept. of Pediatrics, West China Second University Hospital, Sichuan University. No. 20, 3rd section, South Renmin Road Chengdu, 610041, China.Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China; The Cardiac development and early intervention unit, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education Chengdu, Sichuan, China; Key Laboratory of Development and Diseases of Women and Children of Sichuan Province, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China; Corresponding author. Dept. of Pediatrics, West China Second University Hospital, Sichuan University No. 20, 3rd section, South Renmin Road Chengdu, 610041, China.Background: Coronary artery dilation (CAD) had rarely been described as a cardiac complication of febrile disease other than Kawasaki disease (KD). There are rare cases complicated by CAD reported in patients with Mycoplasma pneumoniae (MP) infection. Case presentation: A 6-year-old boy with severe Mycoplasma pneumoniae pneumonia (MPP) was transferred to our hospital due to significant respiratory distress on the 11th day from disease onset. Nadroparin, levofloxacin, and methylprednisolone followed by oral prednisone were aggressively prescribed. His clinical condition gradually achieved remission, and the drugs were withdrawn on the 27th day. Regrettably, the recurrent fever attacked him again in the absence of infection-toxic manifestations. Necrotizing pneumonia (NP) was found on chest CT. And echocardiography revealed right CAD (diameter, 3.40mm; z-score, 3.8), however, his clinical and laboratory findings did not meet the diagnostic criteria of KD. CAD was proposed to result from MP infection, and aspirin was prescribed. Encouragingly, the CAD regressed one week later (diameter, 2.50mm; z-score, 1.4). Additionally, the child defervesced seven days after the initiation of prednisone and Nadroparin treatment. The patient was ultimately discharged home on the 50th day. During follow-up, the child was uneventful with normal echocardiography and fully resolved chest CT lung lesions. Conclusions: CAD can develop in patients with severe MP infection. Pediatricians should be alert to the possibility of CAD in patients with severe MP infection and recognize that CAD might also develop in febrile disease rather than KD.http://www.sciencedirect.com/science/article/pii/S2405844023085936Coronary artery aneurysmsMycoplasma pneumoniaFebrile diseasePneumoniaKawasaki disease
spellingShingle Yafei Guo
Lixia Yang
Shuran Shao
Nanjun Zhang
Yimin Hua
Kaiyu Zhou
Fan Ma
Xiaoliang Liu
Coronary artery dilation in children with febrile illnesses other than Kawasaki disease: A case report and literature review
Heliyon
Coronary artery aneurysms
Mycoplasma pneumonia
Febrile disease
Pneumonia
Kawasaki disease
title Coronary artery dilation in children with febrile illnesses other than Kawasaki disease: A case report and literature review
title_full Coronary artery dilation in children with febrile illnesses other than Kawasaki disease: A case report and literature review
title_fullStr Coronary artery dilation in children with febrile illnesses other than Kawasaki disease: A case report and literature review
title_full_unstemmed Coronary artery dilation in children with febrile illnesses other than Kawasaki disease: A case report and literature review
title_short Coronary artery dilation in children with febrile illnesses other than Kawasaki disease: A case report and literature review
title_sort coronary artery dilation in children with febrile illnesses other than kawasaki disease a case report and literature review
topic Coronary artery aneurysms
Mycoplasma pneumonia
Febrile disease
Pneumonia
Kawasaki disease
url http://www.sciencedirect.com/science/article/pii/S2405844023085936
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