title: Concomitant dengue infection and Kawasaki disease in an infant: a case report and literature review.
abstract: A previously healthy 11-month-old girl presented with fever and rash for 6 days. Physical examination revealed an irritable infant with a high fever, injected conjunctivae, red cracked lips, posterior auricular lymphadenopathy, hepatomegaly, generalized erythematous maculopapular rash and petechial hemorrhage on trunk, face and extremities. Complete blood count showed atypical lymphocytosis and thrombocytopenia. Dengue infection was initially diagnosed. The persistent fever and clinical manifestations of Kawasaki disease (KD) were observed on day 8 with high erythrocyte sedimentation rate (56 mm/hr). Treatment of KD included intravenous immunoglobulin on day 9 of the illness. Desquamation of the fingers was found on day 15 of the illness. Ectasia of left coronary artery with small aneurysmal dilatation was detected by echocardiography on day 15 of the illness. Hemagglutination-inhibition test and enzyme-linked immunosorbent assay for dengue virus eventually showed a four-fold rising. According to the literature review, this is the second reported case of dengue infection concomitant with KD. The natural course of each disease may be modified and causes some difficulties in diagnosis and management.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Rama IV Rd, Bangkok 10330, Thailand.
authors.forename: Jutarat
authors.initials: J
authors.lastname: Mekmullica
authors.forename: Chitsanu
authors.initials: C
authors.lastname: Pancharoen
authors.forename: Jitladda
authors.initials: J
authors.lastname: Deerojanawong
authors.forename: Pornthep
authors.initials: P
authors.lastname: Lertsapcharoen
authors.forename: Usa
authors.initials: U
authors.lastname: Thisyakorn
authors.forename: Chule
authors.initials: C
authors.lastname: Thisyakorn
mesh_terms: D003715:Dengue / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D007223:Infant; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications*