Abstract
Since the clinical feature of Kawasaki disease is similar to that of infective diseases caused by superantigen toxins, the relationship between Kawasaki disease and the superantigen has been investigated. We encountered a patient diagnosed as having Kawasaki disease, who was found to have bacteremia of toxic shock syndrome toxin-1 (TSST-1) producing S. aureus. This report may provide some clues for better understanding the cause of Kawasaki disease. A 2-year-old boy was admitted to our hospital because of prolonged high fever. White blood cell count was 15500/mm3 and serum C-reactive protein level was 219 mg/l on admission (day 3). We started the treatment using antibiotics, PAPM/BP. Because polymorphous rash, erythema of palms and soles, swelling of hands and feet, strawberry tongue, fissured erythematous lips and cervical lymphadenopathy developed in addition to fever on day 4, we started the treatment using gamma-globulin and aspirin following the diagnosis of Kawasaki disease. Swelling and pain of the right knee joint also developed on day 5. All of the symptoms regressed until day 8. No cardiac complications other than mild pericardial effusion were shown in echocardiography during the course. S. aureus was detected in the blood culture taken on admission. PCR testing revealed that the strain had TSST-1, Staphylococcal enterotoxin(SE)C, SEG and SEI, but neither Exfoliative toxin A nor B. Western blotting revealed that IgM anti-TSST-1 was positive in the serum taken in his convalescent period.
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Kajino, M., Sakata, H., Manabe, H. et al. Bacteremia of Toxic Shock Syndrome Toxin-1 Producing Staphylococcus aureus Caused Symptoms of Kawasaki Disease in a Two-year-old Boy. Pediatr Res 53, 168 (2003). https://doi.org/10.1203/00006450-200301000-00089
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DOI: https://doi.org/10.1203/00006450-200301000-00089