Ocho Kazuki, Iwamuro Masaya, Hasegawa Kou, Hagiya Hideharu, Rai Kammei, Yumoto Tetsuya, Otsuka Fumio
Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan.
Division of Infection Control and Prevention, Osaka University Hospital, Japan.
Intern Med. 2018 Feb 1;57(3):437-440. doi: 10.2169/internalmedicine.9250-17. Epub 2017 Nov 1.
A previously healthy 31-year-old man was referred to us with refractory septic shock accompanied by bilateral conjunctival congestion and erythema of his right lower limb. Nine days after admission, he had bilateral desquamation of the fingertips, and his presentation satisfied the criteria for Kawasaki disease. A serological examination was positive for Yersinia pseudotuberculosis, and he was diagnosed with Far East scarlet-like fever (FESLF). Interestingly, his 11-month-old baby boy had similar symptoms around the same time, indicating the intrafamilial transmission of the pathogen. We should consider FESLF when we encounter a familial occurrence of systemic manifestations of Kawasaki disease.
一名31岁既往健康的男性因难治性感染性休克、双侧结膜充血及右下肢红斑被转诊至我院。入院九天后,他出现双侧指尖脱皮,其临床表现符合川崎病的诊断标准。血清学检查显示假结核耶尔森菌阳性,他被诊断为远东猩红热样发热(FESLF)。有趣的是,他11个月大的男婴在同一时间出现了类似症状,提示病原体在家庭内传播。当我们遇到川崎病全身表现呈家族性发病时,应考虑FESLF。