Yersinia pseudotuberculosis type 4a Infection Meeting the Diagnostic Criteria for Kawasaki Disease Complicated by Disseminated Intravascular Coagulation

概要

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We report a case of Yersinia pseudotuberculosis (Y. ptbc) infection complicated by disseminated intravascular coagulation (DIC) that presented as Kawasaki disease (KD). A 9-year-old girl had been well until two days before, when she developed a fever, exanthem, and abdominal pain. An erythematous macular rash was observed in the perineum, and she had astrawberry tongue. The patient was admitted to Kawasaki Medical School Hospital because the macular rashspread over her entire body, and edema of her hands and conjunctivitis subsequently developed.Echo cardiography showed dilation of the left coronary artery. Thrombocytopenia and an elevatedtotal fibrin degeneration product level were noted on the third hospital day, and the prothronmbinand partial-thromboplastin times were prolonged. Her clinical presentation was typical of KD and DIC. A stool culture and a blood culture were negative. Serologic tests were positive for antibodies to Y. ptbc. The antibody titer against Y. ptbc-derived mitogen was not elevated after her recovery. Y. ptbc infection should be considered in an older child whose clinical findings fulfill the criteriafor KD complicated by DIC.
The Japanese Association for Infectious Diseasesの論文