柯萨奇病毒A6感染与川崎病并存:一例报告
Concurrent Coxsackievirus A6 Infection and Kawasaki Disease: A Case Report.
作者信息
Puenpa Jiratchaya, Saelim Noree, Wanlapakorn Nasamon, Korkong Sumeth, Yorsaeng Ritthideach, Poovorawan Yong
机构信息
Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.
Department of Pediatrics, Phitsanulok Bangkok Hospital, Phitsanulok 65000, Thailand.
出版信息
Reports (MDPI). 2024 Nov 15;7(4):98. doi: 10.3390/reports7040098.
Kawasaki disease (KD) is an acute febrile vasculitis that primarily affects children and is associated with systemic inflammation, particularly in the coronary arteries. Coxsackievirus A6 (CVA6) has emerged as a significant agent in atypical presentations of hand, foot, and mouth disease (HFMD), raising the possibility of its involvement in KD. This report presents the case of an 18-month-old Thai boy admitted with symptoms of high fever, sore throat, and ulcerative lesions, initially diagnosed with herpangina. As his condition progressed, additional KD symptoms developed, including conjunctival injection, rash, and elevated inflammatory markers, fulfilling the diagnostic criteria for KD. Notably, throat swab analysis confirmed CVA6 as the causative agent. Phylogenetic analysis revealed that the CVA6 strain closely aligned with Chinese strains from 2023, showing a high nucleotide sequence homology of 98.4%. In conclusion, this case highlights a possible association between CVA6-associated herpangina and KD, suggesting that CVA6 infection may act as a trigger for KD in genetically susceptible children. These findings highlight the need for increased awareness among healthcare providers to promptly identify and manage Kawasaki Disease during peak enterovirus seasons, reducing its impact on children.
川崎病(KD)是一种主要影响儿童的急性发热性血管炎,与全身炎症相关,尤其是冠状动脉炎症。柯萨奇病毒A6(CVA6)已成为手足口病(HFMD)非典型表现中的重要病原体,这增加了其与川崎病有关的可能性。本报告介绍了一名18个月大的泰国男孩的病例,他因高烧、喉咙痛和溃疡性病变症状入院,最初被诊断为疱疹性咽峡炎。随着病情发展,出现了额外的川崎病症状,包括结膜充血、皮疹和炎症标志物升高,符合川崎病的诊断标准。值得注意的是,咽拭子分析证实CVA6为病原体。系统发育分析显示,该CVA6毒株与2023年的中国毒株密切相关,核苷酸序列同源性高达98.4%。总之,本病例突出了CVA6相关疱疹性咽峡炎与川崎病之间可能存在的关联,表明CVA6感染可能是遗传易感儿童川崎病的触发因素。这些发现凸显了医疗服务提供者在肠道病毒高发季节提高认识,以便及时识别和管理川崎病、减轻其对儿童影响的必要性。