401. Kawasaki disease following Rocky Mountain spotted fever: a case report
- Author
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Steven W. Kairys and Aswine K Bal
- Subjects
Medicine(all) ,medicine.medical_specialty ,Pathology ,business.industry ,Intravenous Immune Globulin ,Rocky Mountain spotted fever ,lcsh:R ,lcsh:Medicine ,Toxic shock syndrome ,General Medicine ,medicine.disease ,Dermatology ,Leptospirosis ,hemic and lymphatic diseases ,Case report ,Ehrlichiosis (canine) ,medicine ,Infectious etiology ,Kawasaki disease ,cardiovascular diseases ,skin and connective tissue diseases ,business ,Systemic vasculitis - Abstract
Introduction Kawasaki 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 presentation We 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. Conclusion 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.
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