Kawasaki Disease with Influenza A Virus and Mycoplasma pneumoniae Infections: A Case Report and Review of Literature

Hyeok Soo Moon; Jae Seong Huh; Mi Kyung Kim; Mulakwa Morisho Lambert

doi:10.14776/piv.2016.23.2.149

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Moon, Huh, Kim, and Lambert: Kawasaki Disease with Influenza A Virus and Mycoplasma pneumoniae Infections: A Case Report and Review of Literature

Case Report

Pediatr Infect Vaccine 2016;23(2):149-154.

Published online: 20 January 2016

DOI: https://doi.org/10.14776/piv.2016.23.2.149

Kawasaki Disease with Influenza A Virus and Mycoplasma pneumoniae Infections: A Case Report and Review of Literature

Hyeok Soo Moon¹, Jae Seong Huh¹, Mi Kyung Kim^1,, Mulakwa Morisho Lambert²

¹Department of Pediatrics, Presbyterian Medical Center, Jeonju, Republic of Korea

²Department of Pediatrics, Nyamibungu Referral Hospital, South Kivu, D.R. Congo

Correspondence: Mi Kyung Kim Department of Pediatrics, Presbyterian Medical Center, Jeonju, Korea Tel: +82-63-230-1390, Fax: +82-63-230-1399 E-maili Kmik7@hanmail.net

Received 1 January 2016 Revised 11 March 2016 Accepted 5 May 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Although an association of Kawasaki disease (KD) with infectious agents has been suggested, none have been proven to cause KD. In this case study, we present a case of KD with concurrent onset of influenza and Mycoplasma pneumoniae (MP) infections. A 27-month-old boy presented with prolonged fever, cough, and rhinorrhea. During the initial testing, influenza A infection was identified, and he was treated with oseltamivir. Despite the antiviral therapy, the fever persisted, and he had cervical lymph node enlargement, bilateral conjunctival injection, fissured red lips, strawberry tongue, and erythematous skin lesions on the Bacillus Calmette-Guérin vaccination site. Thus, the patient was diagnosed with KD and was treated with intravenous immunoglobulin (IVIG). The result of the initial antimycoplasma immunoglobulin M (lgM) antibody testing and was positive, and an increased IgM titer from baseline was found in a repeat test. We reviewed the hypotheses on pathogens known to be associated with KD and the etiology of KD. Based on our findings, we suspect that symptoms of KD and coronary artery lesions can occur from various infections besides those caused by Mycoplasma species and influenza viruses.

Keywords: Kawasaki disease, Mycoplasma pneumoniae, Influenza A

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