Yoshino Atsunori, Tanaka Risa, Takano Tadamasa, Oishi Tsutomu
Department of Microbiology and Immunology, Saitama Children's Medical Center, Saitama City, Saitama, Japan.
Department of Pediatrics, Koshigaya Hospital, Dokkyo Medical University, Koshigaya, Saitama, Japan.
Pediatr Int. 2017 Mar;59(3):375-377. doi: 10.1111/ped.13214.
Herein we describe the cases of two afebrile patients who were thought to have Kawasaki disease (KD). Patient 1 was a 7-month-old-Japanese girl. She presented with bulbar conjunctival injection, diarrhea, skin erythema, and redness around the bacillus Calmette-Guerin (BCG) inoculation site. Thirteen days after the first symptoms, ultrasonic cardiogram (UCG) showed dilatations of the bilateral coronary arteries (CA). The dilatations had completely resolved 5 months later. Patient 2 was a 13-month-old Japanese boy. He first presented with bulbar conjunctival injection and redness around the BCG inoculation site. Twenty-two days after the first symptoms, UCG indicated bilateral and peripheral CA dilatations. The mild dilatations of the proximal CA remained. Although fever is the principal symptom of KD, some incomplete KD patients may be afebrile. Although it is difficult to diagnose these patients as having KD, redness at the BCG inoculation site may be a clue to the diagnosis.
在此，我们描述了两名被认为患有川崎病（KD）的无发热患者的病例。病例1是一名7个月大的日本女孩。她出现了球结膜充血、腹泻、皮肤红斑以及卡介苗（BCG）接种部位周围发红的症状。首次出现症状13天后，超声心动图（UCG）显示双侧冠状动脉（CA）扩张。5个月后，这些扩张完全消退。病例2是一名13个月大的日本男孩。他最初表现为球结膜充血和BCG接种部位周围发红。首次出现症状22天后，UCG显示双侧及外周CA扩张。近端CA仍有轻度扩张。虽然发热是KD的主要症状，但一些不完全KD患者可能无发热。虽然很难将这些患者诊断为患有KD，但BCG接种部位发红可能是诊断的一个线索。
