Outcome of Kawasaki disease in Barbados.

Kawasaki disease (KD) often presents as an acute multisystem febrile illness which is most often self-limiting. During an 11-year period, 39 patients with KD, aged 11 weeks to 15 years (mean 2.5 years), were admitted to the Queen Elizabeth Hospital, Barbados. Eighty-seven per cent of children were less than 4 years of age. There were 26 males (67%) and 13 females (33%) with a sex ratio of 2:1. A peak occurrence was observed in 1985 and the mean hospital stay of cases was 12.7 days. Treatment regimens included antibiotics in 36 patients (93%), aspirin in 32 (82%) and steroids in 3 (7%). Major complications were observed in 11 patients (26%), with these being gastrointestinal bleeding in 1, broncho-pneumonia in 3 and cardiac abnormalities in 7 (18%). Among the latter were abnormal proximal coronary arteries in 5 patients (2 with dilatation and 3 with aneurysms) and carditis in 2. Other complications included croup (1), hydrops of the gallbladder (2), paralytic ileus (1), and abnormal focal neurological signs in two patients. There were no deaths. Follow-up ranged between one month and four years. Although KD often presents as a benign self-limiting illness, it is extremely important to make a diagnosis early in the course of the illness, institute appropriate therapy and be on the alert for possible fatal complications.