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Comprehensive pathogen detection associated with four recurrent episodes of Kawasaki disease in a patient during a
Hiromichi Hamada1, Tsuyoshi Sekizuka2, Kunihiro Oba3
1Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center , 477-96 Owada-Shinden, Yachiyo, Chiba 2768524 , Japan.
Insights
Recurrent Kawasaki disease (KD) in a child showed a strong association with Streptococcus species, particularly before treatment. This suggests a potential link between bacterial infections and KD onset, warranting further investigation.
Area of Science:
- Pediatric rheumatology
- Infectious disease research
- Molecular diagnostics
Background:
- Kawasaki disease (KD) is the primary childhood vasculitis, with potential pathogen involvement.
- Inconsistent reports exist regarding the specific pathogens linked to KD onset.
- Understanding KD etiology is crucial for effective management and prevention.
Observation:
- A case study involved a 1-year-old boy experiencing four recurrent episodes of KD within a year.
- Next-generation sequencing analyzed pathogen profiles in serum and pharyngeal specimens.
- Bacterial reads, specifically Streptococcus and Haemophilus spp., showed significant correlation with KD episodes.
Findings:
- A strong correlation (R² = 0.9506) was observed between Streptococcus spp. in serum and the first/fourth KD episodes before treatment.
- Streptococcus spp. significantly decreased (P < 0.0001) during the first convalescent phase.
- Pharyngeal sequencing mirrored serum findings, indicating a localized and systemic bacterial presence (R² = 0.6633).
Implications:
- Streptococcus species may play a role in triggering Kawasaki disease episodes.
- Further research is needed to confirm the association between microbial infections and KD pathogenesis.
- This case highlights the potential of next-generation sequencing in identifying infectious triggers for inflammatory diseases.
Introduction:
Kawasaki disease (KD) is the most common multisystem vasculitis in childhood. Pathogens can be associated with the onset of KD. However, a lack of consistency prevails among reports about this disease.
Case Presentation:
For this case of a 1-year-old boy with four recurrent episodes of KD within a year, we analysed profiles of pathogen reads in his serum and pharynx specimens using next-generation sequencing. Comparative analysis of the identified bacterial reads from serum samples found significant correlation of bacteria such as Streptococcus and Haemophilus spp. with the first and fourth episodes (R2 = 0.9506) before treatment. In the first convalescent phase, the number of Streptococcus spp. was reduced remarkably (P < 0.0001). From sequencing of the pharynx specimen from the fourth episode, a similar correlation was found with serum from the fourth episode (R2 = 0.6633).
Conclusion:
In this case, Streptococcus spp. may have been associated with onset of KD. Further studies must be undertaken to evaluate the putative association of micro-organism infection with KD pathogenesis.
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