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Incomplete Kawasaki disease associated with complicated Streptococcus pyogenes pneumonia: A case report

Timothy Ronan Leahy1, Eyal Cohen, Upton D Allen

  • 1Children's University Hospital and Institute of Molecular Medicine, Trinity Centre for Health Sciences, St James's Hospital, Dublin, Ireland; ; Division of Infectious Diseases; Division of Paediatric Medicine, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario.

The Canadian Journal of Infectious Diseases & Medical Microbiology = Journal Canadien Des Maladies Infectieuses Et De La Microbiologie Medicale
|September 3, 2013
PubMed

Insights

This case report details a child with Streptococcus pyogenes pneumonia who developed incomplete Kawasaki disease. It highlights the importance of echocardiography for diagnosing this condition in children with persistent fever.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Cardiology

Background:

  • Community-acquired pneumonia can present with serious complications.
  • Kawasaki disease is a leading cause of acquired heart disease in children.
  • Incomplete Kawasaki disease may lack classic diagnostic criteria.

Observation:

  • A 3-year-old boy with empyema due to Streptococcus pyogenes developed persistent fever, lethargy, and anorexia post-treatment.
  • Initial inflammatory markers were elevated, but repeat cultures were negative.
  • Echocardiography revealed coronary artery dilation despite the absence of typical mucocutaneous signs.

Findings:

  • The patient was diagnosed with incomplete Kawasaki disease.
  • Treatment with intravenous immunoglobulin and acetylsalicylic acid led to rapid fever resolution.
  • This is the first reported case of Kawasaki disease associated with complicated Streptococcus pyogenes pneumonia.

Implications:

  • Persistent fever in children warrants thorough investigation, even without classic symptoms.
  • Echocardiography plays a crucial role in diagnosing incomplete Kawasaki disease.
  • Superantigen-producing bacteria like Streptococcus pyogenes may be linked to Kawasaki disease pathogenesis.

Keywords:
Coronary arteritisGroup A streptococcusIntravenous immunoglobulinKawasaki diseaseStreptococcus pyogenes

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