Article in Japanese

Incomplete Kawasaki disease after infection with respiratory syncytial virus and human metapneumovirus

Kumpei SEKINE¹⁾, Kenichi OKUMURA¹⁾, Jun SHINOZUKA¹⁾

We describe a patient with incomplete Kawasaki disease (KD) and respiratory co-infection with human metapneumovirus and respiratory syncytial (RS) virus.
An 8-month-old girl with fever and cough was admitted to our hospital, and the results of a rapid examination were positive for human metapneumovirus and RS virus. Antibiotics administered after admission due to an extreme inflammatory response did not improve her symptoms. Erythema developed in her lips, hands and abdomen, edema developed in her hands and feet and her blood BNP value was high. Incomplete KD was diagnosed and treated with intravenous immunoglobulin (IVIG) and oral aspirin, which soon resolved her symptoms including a high fever. Viral co-infection can cause KD according to previous reports. A concurrent respiratory infection and incomplete KD symptoms complicated the differential diagnosis of KD and delayed appropriate therapy for this patient. The increased BNP value helped to diagnose atypical KD quickly.

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1) Division of Pediatrics, Uji-Tokushukai Hospital

Key words	Kawasaki disease, respiratory syncytial (RS) virus, human metapneumovirus, brain natriuretic peptide (BNP)
Received	July 13, 2020
Accepted	March 25, 2021

33 (2)：149─154,2021