Kumar Ratan, Mishra Adyasha, Diwakar Kumar, Tanti Sanjay K
Pediatric Intensive Care Unit, Tata Main Hospital, Jamshedpur , IND.
Pediatrics, Tata Main Hospital, Jamshedpur, IND.
Cureus. 2024 Jun 5;16(6):e61726. doi: 10.7759/cureus.61726. eCollection 2024 Jun.
Kawasaki disease (KD), formerly called mucocutaneous lymph node syndrome, is one of the common vasculitides of childhood. KD most commonly occurs in children over six months up to five years of age, although it can occur in young infants, older children, and adults. Early diagnosis is critical to achieving optimal treatment. We present a case of a three-year-old female child who was admitted with a fever for five days and fulfilled the diagnostic clinical criteria for KD. She was given intravenous immunoglobulin (IVIG) and aspirin. However, the fever persisted, and a urine culture showed the growth of Klebsiella pneumoniae. We started an antibiotic based on her sensitivity. Since fever spikes were not subsiding, she was given a repeat dose of IVIG along with an oral corticosteroid for refractory KD, after which she showed clinical improvement. This case highlighted that refractory KD can coexist with infection.
川崎病（KD），以前称为皮肤黏膜淋巴结综合征，是儿童常见的血管炎之一。KD最常发生于6个月至5岁的儿童，不过也可发生于幼儿、大龄儿童及成人。早期诊断对于实现最佳治疗至关重要。我们报告一例3岁女童，因发热5天入院，符合KD的诊断临床标准。给予其静脉注射免疫球蛋白（IVIG）和阿司匹林。然而，发热持续存在，尿培养显示肺炎克雷伯菌生长。根据药敏结果开始使用抗生素。由于高热未消退，给予她重复剂量的IVIG以及口服糖皮质激素治疗难治性KD，之后她的临床症状有所改善。该病例突出表明难治性KD可与感染并存。
