Bülent KARA, Aynur AKBULUT, Sait UÇAN, Arzu ŞENGÖZ, Emin Sami ARISOY

Staphylococcus aureus bakteriyemisine eşlik eden Kawasaki hastalığı: Vaka sunumu

Kawasaki hastalığının etiyolojisinde bakteriyel toksin ve süperantijenler sorumlu tutulmaktadır. Ateş ve döküntü yakınmasıyla getirilen, kan kültüründe metisiline duyarlı Staphylococcus aureus üreyen on bir aylık hastada ağız ve dudak mukozası değişiklikleri gözlenince eksik ölçütlü Kawasaki hastalığı ön tanısıyla ateşin dördüncü gününde intravenöz immunglobulin (İVİG) ve Asetil salisilik asit (ASA) tedavisine başlandı. Başlangıç İVİG tedavisine yanıt alınamayınca, inflamasyon bulgularının baskılanması için ikinci doz İVİG uygulandı. Hastalık aktivitesi 20. günde baskılanabildi, 4 ve 8. haftalarda ekokardiyografi normal saptandı. Mikroorganizmalarla ilişki, atipik seyir, özgül lenf bezi tutulumu, erken İVİG tedavisi ve başlangıç İVİG tedavisine yanıtsızlık gözden geçirildi.

Anahtar Kelimeler:

Staphylococcus aureus, Mukokutanöz lenf düğümü sendromu, İmmünoglobulinler, Lenfatik hastalıklar, Bakteriyemi

A patient with Kawasaki disease accompanying to Staphylococcus aureus bacteremia

Although the etiology of Kawasaki disease is unclear, one hypothesis suggest that it is a response to bacterial toxins and superantigens. Atypical Kawasaki disease was diagnosed in an eleven-month-old male infant who had fever, rash and oral mucosal inflammation. Staphylococcus aureus was identified from blood culture, intravenous immunglobulin (IVIG) and acetyl salysilic acid were administered on the fourth day of the disease. A second administration of IVIG was required for suppression of inflammation. Activity of the disease was suppressed on the 20th day, and echo-cardiography was normal at 4th and 8th weeks. Role of the microorganisms, atypical course, specific lymph node involvement, early administration of IVIG therapy and non-responsiveness to initial IVIG therapy were reviewed.

Keywords:

Staphylococcus aureus, Mucocutaneous Lymph Node Syndrome, Immunoglobulins, Lymphatic Diseases, Bacteremia,

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