Abstract
IntroductionKawasaki disease is an idiopathic acute systemic vasculitis of childhood. Although it simulates the clinical features of many infectious diseases, an infectious etiology has not been established. This is the first reported case of Kawasaki disease following Rocky Mountain spotted fever.Case presentationWe report the case of a 4-year-old girl who presented with fever and petechial rash. Serology confirmed Rocky Mountain spotted fever. While being treated with intravenous doxycycline, she developed swelling of her hands and feet. She had the clinical features of Kawasaki disease which resolved after therapy with intravenous immune globulin (IVIG) and aspirin.ConclusionThis case report suggests that Kawasaki disease can occur concurrently or immediately after a rickettsial illness such as Rocky Mountain spotted fever, hypothesizing an antigen-driven immune response to a rickettsial antigen.
Highlights
Kawasaki disease is an idiopathic acute systemic vasculitis of childhood
Case presentation: We report the case of a 4-year-old girl who presented with fever and petechial rash
While being treated with intravenous doxycycline, she developed swelling of her hands and feet. She had the clinical features of Kawasaki disease which resolved after therapy with intravenous immune globulin (IVIG) and aspirin. This case report suggests that Kawasaki disease can occur concurrently or immediately after a rickettsial illness such as Rocky Mountain spotted fever, hypothesizing an antigen-driven immune response to a rickettsial antigen
Summary
Kawasaki disease (KD) is an acute febrile systemic vasculitis of childhood and is the leading cause of acquired heart disease in children in the United States and Japan [1]. Rocky Mountain spotted fever (RMSF) and treated successfully During her acute illness, she developed clinical features of Kawasaki disease, which resolved with intravenous immune globulin (IVIG) and aspirin therapy. She developed redness and non-pitting swelling of her hands and feet She received IGIV at a dose of 2 g/kg along with aspirin at a dose of 100 mg/kg/day for Kawasaki disease. CSF for viral culture and enterovirus polymerase chain reaction (PCR) were negative She received highdose aspirin (80 mg/kg/day) until she remained afebrile for 96 hours following which she was placed on low-dose aspirin (4 mg/kg/day) for 6 weeks. Her ECG and echocardiogram were normal at 3 and 6 weeks after the onset of her illness.
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