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Article in Japanese

A case of vYersinia enterocolitica infection with mesenteric lymphadenitis and Kawasaki disease-like symptoms

Kazushi TSURUGA1) , Kazuhiko SUGIMOTO1)

While Yersinia pseudotuberculosis (Y. pstb) is known to show Kawasaki disease-like symptoms, but there are few reports on Yersinia enterocolitica (Y. ent ). A 14-year-old boy complained of fever and abdominal pain and rash on his trunk and limbs. Computed tomography showed swelling lymph nodes around the superior mesenteric artery, and a blood examination revealed an increase in inflammatory response; therefore, he was referred to our hospital. He was treated with cefmetazole for mesenteric lymphadenitis. From the next day, his abdominal pain improved, but his bilateral conjunctival redness and strawberry tongue appeared. He had no coronary artery lesions and was prone to fever reduction; therefore, he was discharged on the 9th hospital day. He presented with desquamation of his limbs and satisfied five of the six main symptoms of Kawasaki disease. No dominant bacteria were found in the stool culture, but a significant increase in antibody titer of Y. ent (serotype O3) was observed in the convalescent serum, and the patient’s illness was diagnosed as Y. ent infection. Although in rare cases, Y. ent infection may present with Kawasaki disease-like symptoms; thus, it is important to recognize these symptoms as one of the complications of this infection.

Department of Pediatrics, Hirosaki National Hospital

Key words Yersinia enterocolitica, Kawasaki disease, mesenteric lymphadenitis, superantigen
Received October 27, 2021
Accepted February 15, 2022

34 (1):3─9,2022