Yersinia pseudotuberculosis infection in children, resembling Izumi fever and Kawasaki syndrome.

Yersinia pseudotuberculosis infection was diagnosed in 12 children on the basis of recovery of the organism from stool cultures and a 4-fold or greater titer change in agglutinating antibody. Eight of the 12 Yersinia isolates were recovered from stool cultures only after cold enrichment. Clinical findings in 50% or more of patients were fever, rash, diarrhea, desquamation, strawberry tongue, vomiting, red and cracked lips, abdominal pain, arthralgias, hepatomegaly and conjunctivitis. The patients' clinical manifestations and courses of illness resembled those of Izumi fever, an illness that occurs epidemically in Japan. Additionally the finding in two children fulfilled the strict criteria for Kawasaki syndrome, and signs in the other 10 children were consistent with that diagnosis.