Abstract:
Kawasaki disease (KD), formerly called mucocutaneous lymph node syndrome, is one of the common vasculitides of childhood. KD most commonly occurs in children over six months up to five years of age, although it can occur in young infants, older children, and adults. Early diagnosis is critical to achieving optimal treatment. We present a case of a three-year-old female child who was admitted with a fever for five days and fulfilled the diagnostic clinical criteria for KD. She was given intravenous immunoglobulin (IVIG) and aspirin. However, the fever persisted, and a urine culture showed the growth of Klebsiella pneumoniae. We started an antibiotic based on her sensitivity. Since fever spikes were not subsiding, she was given a repeat dose of IVIG along with an oral corticosteroid for refractory KD, after which she showed clinical improvement. This case highlighted that refractory KD can coexist with infection.
摘要:
川崎病(KD),以前叫做皮肤粘膜淋巴结综合征,是儿童时期常见的血管炎之一。KD最常见于六个月以上至五岁的儿童,虽然它可以发生在年幼的婴儿身上,年龄较大的孩子,和成年人。早期诊断对于实现最佳治疗至关重要。我们介绍了一例三岁的女性儿童,该儿童因发烧而入院五天,并符合KD的诊断临床标准。给予静脉注射免疫球蛋白(IVIG)和阿司匹林。然而,发烧持续,尿液培养显示肺炎克雷伯菌的生长。我们根据她的敏感性开始了抗生素。由于发烧高峰没有消退,她接受了重复剂量的IVIG以及口服皮质类固醇治疗难治性KD,之后,她表现出临床改善。该病例强调难治性KD可与感染共存。