Clinical Aspects of Scrub Typhus Initially Misdiagnosed as Kawasaki Disease

Abstract

Objectives: To analyze the clinical characteristics of scrub typhus (ST) initially misdiagnosed as Kawasaki disease (KD) in children. Methods: This study was conducted through a review of medical records of children with ST from March 2005 to June 2015. Results: Among 182 incomplete KD patients, 11 patients were ST. Red lips, strawberry tongue, and BCG site redness were not reported. Presence of eschars was reported in 5 patients. Group 1 patients (n = 6) were initially treated by using intravenous immunoglobulin (IVIG) and among them, one patient had an eschar after IVIG use. Group 2 patients (n = 5) were also initially diagnosed as KD but were not treated because eschar was detected in four patients before use of IVIG. One patient had no eschar but had a positive serologic test before IVIG use. Conclusions: When children have symptoms similar to KD but without red lips and strawberry tongue, clinicians should search for an eschar and perform serologic tests for ST.