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Article in Japanese

Viral reactivation of Bacillus Calmette–Guérin, initially suspected to be Kawasaki disease-induced

Takahiro FUJII1), Tomo SAWADA2), Kenji BANDOU2), Seiko MURAKAMI2)

Bacillus Calmette-Guérin (BCG) reactivation frequently occurs in patients with Kawasaki disease, especially in young children. Therefore, it is documented as one of the main symptoms in the Japanese guidelines for Kawasaki disease diagnosis (version 6) of the Japanese Society of Kawasaki Disease. We report three cases of BCG reactivation in which we identified a virus in the stool samples. The three patients, aged between 10 months and 18 months, presented with fever. BCG reactivation appeared days 2-7 after the appearance of fever. Because all the diagnostic criteria for Kawasaki disease were not fulfilled (only 3-4 symptoms were observed), the patients were not treated with intravenous immunoglobulin. Their symptoms disappeared spontaneously in 4-8 days, and no coronary artery lesion was observed. Later, we detected one of the following viruses in each of their stool samples: parechovirus types 1 and 4, and adenovirus type 1. Although BCG reactivation is an important diagnostic indicator for Kawasaki disease, we conclude that similar reactivation can also be induced by some viral infections.

1) Department of Pediatrics, Osaka City University Hospital
2) Department of Pediatrics, Izumi City General Hospital

Key words Bacillus Calmette-Guérin, Kawasaki disease, parechovirus, adenovivirus
Received April 20, 2020
Accepted November 9, 2020

32 (4):380─385,2020