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The Journal of Pediatric Infectious Diseases and Immunology > Vol.31 No.4 contents > Abstract

Article in Japanese

A case report of Yersinia pseudotuberculosis infection with symptoms of Kawasaki disease and gastrointestinal bleeding

Natsuki NAKAMURA1), Shinya HARA1), Haruka NODA1), Yosuke NISHIO1), Yoshihiko KAWANO1)

Yersinia pseudotuberculosis (Y. pstb) infection in childhood is known to cause fever, diarrhea and vomiting, as well as Kawasaki disease-like symptoms including conjunctival hyperemia, strawberry tongue, rash, and desquamation of the hands or feet.
Herein, a case is reported of Kawasaki disease with upper gastrointestinal bleeding, which was diagnosed finally as Y. pstb infection. A 3-year-old boy presented with fever, hematemesis and melena. Based on the symptoms (5-day-fever, red eyes, red lips, neck lymph node swelling, and rash on his back), he was diagnosed with Kawasaki disease. Furthermore, gastric ulcers were confirmed by upper gastrointestinal endoscopy. He was treated with immunoglobulin and flurbiprofen for Kawasaki disease, and lansoprazole for the gastric ulcers.
This patient had drank well water, and Y. pstb infection was diagnosed serologically, although the same bacteria were not detected in the well water.
Little has been reported about the complication of upper gastrointestinal bleeding in Kawasaki disease patients before treatment with aspirin. This case suggests that Y. pstb infection may be associated with upper gastrointestinal bleeding.

1) Department of Pediatrics, Toyota Memorial Hospital

Key words Kawasaki disease, upper gastrointestinal bleeding, Yersinia infection, Yersinia pseudotuberculosis
Received March 14, 2019
Accepted September 3, 2019

31 (4):361─366,2019