Pathogenic characterization of a cervical lymph node derived from a patient with Kawasaki disease.
Kawasaki disease (KD) is the most common cause of multisystem vasculitis in childhood. Although cervical lymphadenitis is one of the major symptoms in KD, lymph node biopsy is rarely performed, because KD is usually diagnosed by clinical symptoms. A cervical lymph node biopsy was taken from a girl aged 1 year and 8 months who had suspected lymphoma, but she was diagnosed with KD after the biopsy. The cervical lymph node specimen was analyzed with multivirus real-time PCR that can detect >160 viruses, and unbiased direct sequencing with a next-generation DNA sequencer to detect potential pathogens in the lymph node. Histologically, focal necrosis with inflammatory cell infiltration, including neutrophils and macrophages, was observed in the marginal zone of the cervical lymph node, which was compatible with the acute phase of KD. Multivirus real-time PCR detected a low copy number of torque teno virus in the sample. Comprehensive direct sequencing of the cervical lymph node biopsy sample sequenced more than 8 million and 3 million reads from DNA and RNA samples, respectively. Bacterial genomes were detected in 0.03% and 1.79% of all reads in DNA and RNA samples, respectively. Although many reads corresponded to genomes of bacterial environmental microorganisms, Streptococcus spp. genome was detected in both DNA (77 reads) and RNA (2,925 reads) samples. Further studies are required to reveal any association of microbial or viral infection with the pathogenesis of KD.
Department of Pathology, National Institute of Infectious Diseases, Toyama, Shinjuku-ku, Tokyo, Japan. katano@nih.go.jp
Harutaka
H
Katano
Seiichi
S
Sato
Tsuyoshi
T
Sekizuka
Akiko
A
Kinumaki
Hitomi
H
Fukumoto
Yuko
Y
Sato
Hideki
H
Hasegawa
Shigeru
S
Morikawa
Masayuki
M
Saijo
Tetsuya
T
Mizutani
Makoto
M
Kuroda
D004266:DNA Virus Infections; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage; D007223:Infant; D008198:Lymph Nodes / Q000473:pathology* / Q000821:virology; D008199:Lymphadenitis / Q000175:diagnosis* / Q000628:therapy / Q000821:virology; D008223:Lymphoma / Q000175:diagnosis; D009080:Mucocutaneous Lymph Node Syndrome / Q000175:diagnosis* / Q000628:therapy / Q000821:virology; D009333:Neck; D009336:Necrosis; D022783:Torque teno virus / Q000302:isolation & purification; D016896:Treatment Outcome
D016756:Immunoglobulins, Intravenous