BAHAR BÜYÜKKARAGÖZ, Sibğatllah Ali ORAK, Gülten KÜÇÜKKAYALI, Ali Osman KÖKSAL, Nesibe ANDIRAN, Osman ÖZDEMİR, Aysun YILMAZ ÇALTIK

İlk bulgusu steril piyüri olan bir Kawasaki hastalığı olgusu

Kawasaki hastalığı (KH) çocukluk çağı multisistemik vas- külitidir. Tedavi edilmemiş olan olguların %20-25 inde hastalığın ilk 2-3. haftasında koroner arter anevrizması gelişebileceğinden erken tanı ve tedavi önem taşır. Steril piyüri hastalığın aktif döneminde en sık görülen idrar bul- gusu olup, daha ağır sistemik enflamasyon varlığına işa- ret eder. Bu çalışmada yüksek ateş nedeniyle başvuran, piyüriyle birlikte akut faz belirteçlerinde yükseklik sap- tanarak akut piyelonefrit ön tanısıyla antibiyotik tedavisi başlanan, izleminde ateşin sebat etmesi, idrar kültüründe üreme olmaması ve cilt, mukoza ve konjonktiva değişik- lerinin ortaya çıkmasıyla inkomplet KH tanısı alan 3,5 ya- şında bir erkek olgu sunulmuştur. Bu nedenle KHda uza- mış ateşle birlikte steril piyürinin hastalık için tipik belirtiler henüz ortaya çıkmadan ilk başvuru bulgusu olabileceği de akılda tutulmalıdır.

Sterile pyuria as the initial finding in a case with Kawasaki disease

Kawasaki disease (KD) is a multi-systemic vasculitis of pediatric age group. Early diagnosis and treatment is cru- cial as coronary artery aneurysms may develop in 20-25% of untreated cases in the 2nd -3rd weeks of the disease. The most common urinary finding in the active period is sterile pyuria; which is believed to be a sign of a more severe systemic inflammation. In this study, a 3.5 year old boy who admitted with high fever was presented. As he had pyuria and elevated acute phase reactants, antibiotic treatment was started with a pre-diagnosis of acute pyelo- nephritis. Later, with the persistence of fever, detection of a negative urine culture result and emergence of dermal, mucosal and conjunctival changes, incomplete KD was diagnosed. In conclusion, it should be remembered that prolonged fever with sterile pyuria can be the initial find- ings in KD; before the emergence of typical lesions

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