title: [Yersinia pseudotuberculosis type 4a infection meeting the diagnostic criteria for Kawasaki disease complicated by disseminated intravascular coagulation].
abstract: We report a case of Yersinia pseudotuberculosis (Y. ptbc) infection complicated by disseminated intravascular coagulation (DIC) that presented as Kawasaki disease (KD). A 9-year-old girl had been well until two days before, when she developed a fever, exanthem, and abdominal pain. An erythematous macular rash was observed in the perineum, and she had a strawberry tongue. The patient was admitted to Kawasaki Medical School Hospital because the macular rash spread over her entire body, and edema of her hands and conjunctivitis subsequently developed. Echo cardiography showed dilation of the left coronary artery. Thrombocytopenia and an elevated total fibrin degeneration product level were noted on the third hospital day, and the prothronmbin and partial-thromboplastin times were prolonged. Her clinical presentation was typical of KD and DIC. A stool culture and a blood culture were negative. Serologic tests were positive for antibodies to Y. ptbc. The antibody titer against Y. ptbc-derived mitogen was not elevated after her recovery. Y. ptbc infection should be considered in an older child whose clinical findings fulfill the criteria for KD complicated by DIC.
authors.affiliation: Department of Pediatrics, Kawasaki Medical School Hospital.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Usui
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Ishii
authors.forename: Hiroto
authors.initials: H
authors.lastname: Akaike
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Isumi
authors.forename: Hayasi
authors.initials: H
authors.lastname: Komura
authors.forename: Kouzou
authors.initials: K
authors.lastname: Kawasaki
authors.forename: Kazunobu
authors.initials: K
authors.lastname: Ouchi
mesh_terms: D002648:Child; D004211:Disseminated Intravascular Coagulation / Q000209:etiology*; D005260:Female; D006801:Humans; D009080:Mucocutaneous Lymph Node Syndrome / Q000175:diagnosis* / Q000382:microbiology*; D015012:Yersinia pseudotuberculosis Infections / Q000150:complications*