In a minority of cases, cytokine blockers have been used as a supplemental therapy to inhibit production of IL-6 (tocilizumab) or IL-1 (anakinra); TNF-α-inhibitors (infliximab) have also been used. Inotropic or vasoactive agents are often used for children with cardiac dysfunction and hypotension. Anticoagulants have been used. Low-dose aspirin has been used as an antiplatelet drug.Treatment strategies are being considered to prevent serious long-term complications such as coronary artery aneurysms (the main complication of Kawasaki disease). Close outpatient follow-up by a paediatric cardiology team has been recommended. Causes
While it has been hypothesized that the condition is related to COVID-19, it has also been emphasized that the potential link  "is neither established nor well understood." A temporal association between SARS-CoV-2 infection and clinical presentation of the syndrome is plausible. A causality assessment found that temporality was among the five (out of nine) Bradford Hill criteria that supported a causal relationship between SARS-CoV-2 infection and the development of the syndrome. Further characterization of the syndrome is essential to identify risk factors and help understand causality. It is unclear to what extent this emerging syndrome has a similar aetiology to Kawasaki disease (a condition predating the emergence of SARS-CoV-2, which is currently thought to be triggered by a distinct viral agent). Although some cases resemble toxic shock syndrome, there is no evidence that staphylococcal or streptococcal toxins are involved. The role of comorbidities is unclear. Improved understanding will have potential implications for clinical management. Genome-wide association studies are expected to provide insights on susceptibility and potential biological mechanisms.
Antibiotic-associated diarrhea (AAD) results from an imbalance in the colonic microbiota caused by antibiotics. Microbiotal alteration changes carbohydrate metabolism with decreased short-chain fatty acid absorption and an osmotic diarrhea as a result. Another consequence of antibiotic therapy leading to diarrhea is overgrowth of potentially pathogenic organisms such as Clostridium difficile. It is defined as frequent loose and watery stools with no other complications. Cause
Clostridium difficile, also known more commonly as C. diff, accounts for 10 to 20% of antibiotic-associated diarrhea cases, because the antibiotics administered for the treatment of certain disease processes such as inflammatory colitis also inadvertently kill a large portion of the gut flora, the normal flora that is usually present within the bowel. With this lower level of "healthy" bacteria present, the overgrowth of C. diff is then responsible "for elaborating the enterotoxin". Treatment
Meta-analyses have concluded that probiotics may protect against antibiotic-associated diarrhea in both children and adults. Evidence is insufficient, however, regarding an effect on rates of C. difficile colitis.Efficacy of probiotic AAD prevention is dependent on the probiotic strain(s) used and on the dosage. Up to a 50% reduction of AAD occurrences has been found. No side effects have been reported. Caution is advised when using probiotics in immunocompromised individuals or those who have a compromised intestinal barrier because of the risk of an infection caused by the probiotic supplements. == References ==