Advanced Search
Korean J Pediatr 2012 December;55(12) :470-473.
Published online 2012 October 22.        doi:
Detection Rate and Clinical Impact of Respiratory Viruses in Children with Kawasaki Disease
Ja Hye Kim (Kim JH)1, Jeong Jin Yu (Yu JJ)1, Jina Lee (Lee JN)1, Mi-Na Kim (Kim NM)2, Hong Ki Ko (Ko HK)1, Hyung Soon Choi (Choi HS)3, Young-Hwue Kim (Kim YH)1, Jae-Kon Ko (Ko JK)1
1Department of Pediatrics, College of Medicine, University of Ulsan, Seoul, Korea
2Department of Laboratory Medicine, College of Medicine, University of Ulsan, Seoul, Korea
3Department of Pediatrics, Kosin University Gospel Hospital, Busan, Korea
Corresponding Author: Jeong Jin Yu ,Tel: +82-2-3010-3924, Fax: +82-2-473-3725, Email:
Copyright © 2012 by The Korean Pediatric Society
Purpose: The purpose of this prospective case-control study was to survey the detection rate of respiratory viruses in children with Kawasaki disease (KD) by using multiplex reverse transcriptasepolymerase chain reaction (RT-PCR), and to investigate the clinical implications of the prevalence of respiratory viruses during the acute phase of KD. Methods: RT-PCR assays were carried out to screen for the presence of respiratory syncytial virus A and B, adenovirus, rhinovirus, parainfluenza viruses 1 to 4, influenza virus A and B, metapneumovirus, bocavirus, coronavirus OC43/229E and NL63, and enterovirus in nasopharyngeal secretions of 55 KD patients and 78 control subjects. Results: Virus detection rates in KD patients and control subjects were 32.7% and 30.8%, respectively (P=0.811). However, there was no significant association between the presence of any of the 15 viruses and the incidence of KD. Comparisons between the 18 patients with positive RT-PCR results and the other 37 KD patients revealed no significant differences in terms of clinical findings (including the prevalence of incomplete presentation of the disease) and coronary artery diameter. Conclusion: A positive RT-PCR for currently epidemic respiratory viruses should not be used as an evidence against the diagnosis of KD. These viruses were not associated with the incomplete presentation of KD and coronary artery dilatation.
Keywords: Coronary aneurysm | Mucocutaneous lymph node syndrome | Respiratory tract infections | Viruses | Reverse transcriptase polymerase chain reaction
1. Bell DM, Brink EW, Nitzkin JL, Hall CB, Wulff H, Berkowitz ID, et al. Kawasaki syndrome: description of two outbreaks in the United States. N Engl J Med 1981;304:1568–1575.
2. Treadwell TA, Maddox RA, Holman RC, Belay ED, Shahriari A, Anderson MS, et al. Investigation of Kawasaki syndrome risk factors in Colorado. Pediatr Infect Dis J 2002;21:976–978.
3. Raymond F, Carbonneau J, Boucher N, Robitaille L, Boisvert S, Wu WK, et al. Comparison of automated microarray detection with real-time PCR assays for detection of respiratory viruses in specimens obtained from children. J Clin Microbiol 2009;47:743–750.
4. Cho EY, Eun BW, Kim NH, Lee J, Choi EH, Lee HJ, et al. Association between Kawasaki disease and acute respiratory viral infections. Korean J Pediatr 2009;52:1241–1248.
5. Jordan-Villegas A, Chang ML, Ramilo O, Mejias A. Concomitant respiratory viral infections in children with Kawasaki disease. Pediatr Infect Dis J 2010;29:770–772.
6. Newburger JW, Takahashi M, Gerber MA, Gewitz MH, Tani LY, Burns JC, et al. 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. Pediatrics 2004;114:1708–1733.
7. Japan Kawasaki Disease Research Committee. Report of subcommittee on standardization of diagnostic criteria and reporting of coronary artery lesions in Kawasaki disease. Tokyo: Ministry of Health and Welfare; 1984.
8. Korea Centers for Disease Control and PreventionAcute infectious agents laboratory surveillance reports [Internet]. Cheongwon: Korea Centers for Disease Control and Prevention; c2012 [2012 Feb 1].
9. Yu JJ, Cho SK, Park YM, Lee R, Chung S, Bae SH. Coronary artery diameter of normal children aged 3 months to 6 years. Korean J Pediatr 2008;51:629–633.
10. Kawasaki T. Acute febrile mucocutaneous syndrome with lymphoid involvement with specific desquamation of the fingers and toes in children. Arerugi 1967;16:178–222.
11. Rowley AH. Finding the cause of Kawasaki disease: a pediatric infectious diseases research priority. J Infect Dis 2006;194:1635–1637.
12. Rowley AH, Baker SC, Shulman ST, Fox LM, Takahashi K, Garcia FL, et al. Cytoplasmic inclusion bodies are detected by synthetic antibody in ciliated bronchial epithelium during acute Kawasaki disease. J Infect Dis 2005;192:1757–1766.
13. Rowley AH, Baker SC, Shulman ST, Rand KH, Tretiakova MS, Perlman EJ, et al. Ultrastructural, immunofluorescence, and RNA evidence support the hypothesis of a "new" virus associated with Kawasaki disease. J Infect Dis 2011;203:1021–1030.
14. Lehmann C, Klar R, Lindner J, Lindner P, Wolf H, Gerling S. Kawasaki disease lacks association with human coronavirus NL63 and human bocavirus. Pediatr Infect Dis J 2009;28:553–554.
PDF Links  PDF Links
Full text via DOI  Full text via DOI
  via Pubmed
Full text via PMC  Full text via PMC
via Pubreader  via PubReader
Download Citation  Download Citation
Supplementary Material  Supplementary Material
Uveitis as an important ocular sign to help early diagnosis in Kawasaki disease  2015 October;58(10)
Update of genetic susceptibility in patients with Kawasaki disease  2015 March;58(3)
Clinical approach to quality of life in children with end-stage renal disease  2013 August;56(8)
Sensorineural hearing loss in patients with Kawasaki disease  2015 November;58(11)
Cardiovascular risk factors of early atherosclerosis in school-aged children after Kawasaki disease  2014 May;57(5)
Register for e-submission
Register here to access the e-submission system of Korean J Pediatr for authors and reviewers.
Manuscript Submission
To submit a manuscript, please visit the Korean J Pediatr e-submission management system at, read the Instructions for Authors, and log into the Korean J Pediatr e-submission system. For assistance with manuscript submission, please contact:
Free archive
Anyone may access any past or current articles without logging in.
Korean Pediatric Society Office
#1606, Seocho World Officetel, 19 Seoun-ro, Seocho-gu, Seoul 137-070, Korea
TEL : +82-2-3473-7305    FAX : +82-2-3473-7307   E-mail:
BrowseCurrent IssueFor Authors and ReviewersAbout
Copyright© The Korean Pediatric Society. All right reserved.