Iio Kazuki, Fukushima Naoya, Akamine Keiji, Uda Kazuhiro, Hataya Hiroshi, Miura Masaru
Department of General Pediatrics, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
Department of Cardiology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
Front Pediatr. 2020 Sep 3;8:562. doi: 10.3389/fped.2020.00562. eCollection 2020.
Kawasaki disease and acute rheumatic fever are two major causes of acquired heart disease in the pediatric population. Although both conditions are well-known entities, the association between them has never been described. We report herein a case of 6-year-old male patient who first presented with Kawasaki shock syndrome, followed by acute rheumatic fever 1 year later. In contrast to the prompt intervention given for atypical Kawasaki disease, in the present case the diagnosis was significantly delayed during the otherwise typical presentation of acute rheumatic fever. Our case highlights the difficulty experienced by many pediatricians in developed nations in diagnosing acute rheumatic fever due to its comparative rarity. To prevent diagnostic errors, all pediatricians should be alert to the possibility of acute rheumatic fever even if they are practicing in areas where it is not endemic.
川崎病和急性风湿热是儿童后天性心脏病的两大主要病因。尽管这两种病症都是广为人知的疾病，但它们之间的关联此前从未被描述过。我们在此报告一例6岁男性患者，该患者最初表现为川崎休克综合征，1年后继而出现急性风湿热。与非典型川崎病得到及时干预不同，在本病例中，急性风湿热典型表现过程中诊断明显延迟。我们的病例凸显出发达国家许多儿科医生因急性风湿热相对罕见而在诊断时所面临的困难。为防止诊断错误，所有儿科医生即使在急性风湿热非地方性流行地区执业，也应警惕其发生的可能性。
