Yersinia pseudotuberculosis type 4a Infection Meeting the Diagnostic Criteria for Kawasaki Disease Complicated by Disseminated Intravascular Coagulation
Department of Pediatrics, Kawasaki Medical School Hospital.Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases 12/2005; 79(11):895-9. DOI: 10.11150/kansenshogakuzasshi1970.79.895
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 a strawberry tongue. The patient was admitted to Kawasaki Medical School Hospital because the macular rash spread 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 elevated total fibrin degeneration product level were noted on the third hospital day, and the prothronmbin and 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 criteria for KD complicated by DIC.
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ABSTRACT: Sir, Although coronary artery involvement is the feature responsible for most of the morbidity in Kawasaki disease (KD), other complications can also occur. We would like to report a case of an infant with KD who had disseminated intravascular coagulation (DIC) as a complication. A five-month-old boy presented with fever of 5 days and a generalized rash noted on the day of admission. Examination showed a well nourished but sick looking infant with a temperature of 103.4 0 F. Multiple erythematous large macules were seen over the face, trunk and proximal parts of limbs. Systemic examination was within normal limits. On the next day the baby developed fissuring of lips and urethral meatitis. There was also mild edema of hands and feet. The baby also had a non-exudative bilateral conjunctival injection. A clinical diagnosis of KD was made. Echocardiogram showed coronary artery ectasia (left main coronary artery 4.4 mm, left anterior descending artery 3.6 mm and right coronary artery 3.2 mm). He was treated with intravenous immunoglobulin (IV-IG) 2 g/Kg single infusion and started on aspirin 100 mg/Kg/day.
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ABSTRACT: The etiology of Kawasaki disease (KD) is still unknown. Recently, an association between human coronavirus NL63 (HCoV-NL63) and KD was implicated. Hence, we attempted to determine the association between KD and acute respiratory viral infections.
Article: Marathon of eponyms: 25 Yersiniosis[Show abstract] [Hide abstract]
ABSTRACT: The use of eponyms has long been contentious, but many remain in common use, as discussed elsewhere (Editorial: Oral Diseases. 2009: 15; 185). The use of eponyms in diseases of the head and neck is found mainly in specialties dealing with medically compromised individuals (paediatric dentistry, special care dentistry, oral and maxillofacial medicine, oral and maxillofacial pathology, oral and maxillofacial radiology and oral and maxillofacial surgery) and particularly by hospital-centred practitioners. This series has selected some of the more recognised relevant eponymous conditions and presents them alphabetically. The information is based largely on data available from MEDLINE and a number of internet websites as noted below: the authors would welcome any corrections. This document summarises data about Yersiniosis.