Incomplete Kawasaki disease associated with complicated Streptococcus pyogenes pneumonia: A case report

A three-year-old boy presented with community-acquired pneumonia complicated by empyema. Streptococcus pyogenes (group A streptococcus) was identified on culture of the pleural fluid. The patient improved with antibiotic therapy and drainage of the empyema. During his convalescence, the patient deve...

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Bibliographic Details
Published inThe Canadian journal of infectious diseases & medical microbiology Vol. 23; no. 3; pp. 137 - 139
Main Authors Leahy, Timothy Ronan, Cohen, Eyal, Allen, Upton D
Format Journal Article
LanguageEnglish
Published Egypt Pulsus Group Inc 2012
Wiley
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Summary:A three-year-old boy presented with community-acquired pneumonia complicated by empyema. Streptococcus pyogenes (group A streptococcus) was identified on culture of the pleural fluid. The patient improved with antibiotic therapy and drainage of the empyema. During his convalescence, the patient developed persistent fever, lethargy and anorexia. His inflammatory markers were elevated, and repeat cultures were negative. Although the patient had none of the classical mucocutaneous features of Kawasaki disease, an echocardiogram was performed, which revealed coronary artery dilation. The patient was diagnosed with incomplete Kawasaki disease and treated with intravenous immunoglobulin and high-dose acetylsalicylic acid. The fever subsided within 48 h. To the authors' knowledge, the present report is the first report of Kawasaki disease associated with complicated S pyogenes pneumonia. It emphasizes the importance of considering incomplete Kawasaki disease among children with persistent fever, the role of echocardiography in diagnosis, and the potential link between Kawasaki disease and superantigen-producing organisms such as S pyogenes.
ISSN:1712-9532
1918-1493
DOI:10.1155/2012/638357