Bal Aswine K, Kairys Steven W
J Med Case Rep. 2009 Jul 6;3:7320. doi: 10.4076/1752-1947-3-7320.
Kawasaki disease is an idiopathic acute systemic vasculitis of childhood. Although it simulates the clinical features of many infectious diseases, an infectious etiology has not been established. This is the first reported case of Kawasaki disease following Rocky Mountain spotted fever.
We report the case of a 4-year-old girl who presented with fever and petechial rash. Serology confirmed Rocky Mountain spotted fever. While being treated with intravenous doxycycline, she developed swelling of her hands and feet. She had the clinical features of Kawasaki disease which resolved after therapy with intravenous immune globulin (IVIG) and aspirin.
This case report suggests that Kawasaki disease can occur concurrently or immediately after a rickettsial illness such as Rocky Mountain spotted fever, hypothesizing an antigen-driven immune response to a rickettsial antigen.
川崎病是一种儿童特发性急性全身性血管炎。尽管它模拟了许多传染病的临床特征，但尚未确定其感染性病因。这是首例报告的落基山斑疹热后发生川崎病的病例。
我们报告了一名4岁女孩的病例，她出现发热和瘀点皮疹。血清学检查确诊为落基山斑疹热。在接受静脉注射强力霉素治疗期间，她出现了手脚肿胀。她具有川崎病的临床特征，经静脉注射免疫球蛋白（IVIG）和阿司匹林治疗后症状缓解。
本病例报告表明，川崎病可能在立克次体病如落基山斑疹热同时或之后立即发生，推测是对抗立克次体抗原的抗原驱动免疫反应。
