Abstract
The etiology of Kawasaki disease remains unknown despite extensive studies. Some researchers suggest that it is caused by an infectious agent. This is a case report where a patient with incomplete Kawasaki disease was found to have evidence compatible with acute Mycoplasma pneumoniae infection. This is one of the several case reports linking Mycoplasma pneumoniae to Kawasaki disease as a possible trigger. This is perhaps due to a superantigen or is mediated by some other mechanism. Accurate and timely testing for Mycoplasma infections is difficult and has its limitations. Despite this, Mycoplasma pneumoniae should be considered in the differential and workup for Kawasaki disease.
Highlights
The etiology of Kawasaki disease remains unknown despite extensive studies
Mycoplasma pneumoniae should be considered in the differential and workup for Kawasaki disease
Acute Mycoplasma pneumoniae infection was made after the Mycoplasma IgM serology came back positive
Summary
Tylenol Azithromycin IVIG and ASA∗6 2nd IVIG/ASA Prednisone/ASA prednisone tapering. ∗1 sore throat/∗2rapid strept test negative/∗3mononucleosis spot test negative/∗4blood culture negative/∗5right coronary artery/∗6aspirin/∗7discharge. The patient continued to spike fevers for three days after IVIG infusion. A second dose of 1 gm/kg IVIG infusion was given, but the inflammatory markers remained elevated and the patient continued to spike fevers throughout. A repeat echocardiogram on day 6 of hospitalization showed progression of the disease with the addition of left main and proximal left anterior descending artery ectasia. The patient was discharged on day 9 of hospitalization with aspirin and a prednisone tapering regimen (Table 1). The patient was discharged home to continue a prednisone tapering and aspirin regimen (Table 2). A repeat echocardiogram 10 days after discharge showed the diameter of the right coronary artery to be in the upper limits of normal, but the left main and descending arteries were more dilated and prominent. Repeat Mycoplasma IgM serology drawn ten months after discharge was negative (Mycoplasma IgM titer ≤0.90)
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