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A Clinical Observation of Kawasaki Meningitis and Viral Meningitis

Journal of the Korean Pediatric Society 1995;38(6):794-803.
Published online June 15, 1995.
A Clinical Observation of Kawasaki Meningitis and Viral Meningitis
Jae-Ho Hyun, Young-Hoon Kim, Ji-Whan Han, Jong-Wan Kim, Kyung-Tai Whang
Department of Pediatrics, Catholic University Medical College, Seoul, Korea
가와사끼 병 뇌막염의 임상적 특성 -바이러스성 뇌막염과의 비교-
현재호, 김영훈, 한지환, 김종완, 황경태
가톨릭대학교 의과대학 소아과학교실
Abstract
Purpose
: This study was performed to investigate the clinical characteristics in Kawasaki meningitis and viral meningitis.
Methods
: A clinical observation and comparison were carried out on 37 patients of Kawasaki disease with meningitis(group A) and 28 patients of Kawasaki disease without meningitis (group B) who were admitted to Catholic Medical Center from July, 1991 to June, 1993 and 100 patients of viral meningitis(group C) who were admitted from April to June, 1993.
Results
: 1) The incidence of aseptic meningitis in Kawasaki disease was 56.9%. 2) The highest incidence was 13 t 24 month old of age in group A, 25 to 36 month old of group B and over 5 year old of group C. 3) The total febrile period was 6 to 10 days(83.8%) in group A and under 5 days(53%) in group C. The others of group A were vomiting(24.0%), abdominal pain(10.8%) and diarrhea(8.1%) in order. But those of group C were headache(87.0%), vomiting(83.0%), vomiting(83.0%), diarrhea(21.0%), abdominal pain(4.0%) and seizure(2.0%) in order. 4) The hematocrit, W.B.C. and platelets were 31 to 33%(54.0%), 10,001 to 15,000/㎕(48.6%), and over 400,000/㎕(40.0%) one another in group A. Those in group C were 36% to 40%(53.0%), under 10,000/㎕(48.6%) and 300,001-400,000/㎕(40.0%). 5) The erythrocyte sedimentation rate and C-reactive protein were over 61mm/hr of 37.8% and +4 to +6 of 59.5% in group A, and under 20mm/hr of 72.0% and +1 to +3 of 54.0% in group C. 6) In CSF examination, cell counts were under 15/㎕ of 48.6% in goup A and 101 to 400/㎕ of 33.0% in group C. 7) The coronary arteries involvements were in 59.5% of group A, as compared with 42.3% of group B. But there is no significant difference between two groups. The meningeal irritation was rare sign in Kwasaki meningitis. The mean cell counts of CSF was significantly lower than in viral meningitis.
Conclusion
: Our results said that the pathogenesis of Kawasaki meningitis is not direct invasion of virus but systermic vasculitis.
Key Words: Kawasaki disease, Aseptic meningitis, Viral meningitis


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