Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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A Case of Kawasaki Disease with Mycoplasma Pneumonia

마이코플라즈마 폐렴 환아에서 병발한 가와사키병 1례

  • Lee, Se Min (Department of Pediatrics, Seoul National University, College of Medicine) ;
  • Park, So Eun (Department of Pediatrics, Seoul National University, College of Medicine) ;
  • Kim, Yeun Woo (Department of Pediatrics, Cheju University, College of Medicine) ;
  • Hong, Jung Yeun (Department of Pediatrics, Cheju University, College of Medicine)
  • 이세민 (서울대학교 의과대학 소아과학교실) ;
  • 박소은 (서울대학교 의과대학 소아과학교실) ;
  • 김연우 (제주대학교 의과대학 소아과학교실) ;
  • 홍정연 (제주대학교 의과대학 소아과학교실)
  • Received : 2004.07.23
  • Accepted : 2004.10.30
  • Published : 2005.04.15
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Abstract

Kawasaki disease is an acute febrile vasculitis that occurs predominantly in young children under 5-years-old. The patients present generally with a high spiking fever that is unresponsive to antibiotics and lasts for more than five days at least. Prolonged fever has been shown to be a risk factor in the development of coronary artery disease. It seems to be certain that infectious agents are associated with the pathogenesis of Kawasaki disease. The differential diagnosis of Kawasaki disease must rule out infectious diseases including scarlet fever, toxic shock syndrome, measles, and so on. This is very important for adequate treatment and prevention of cardiac complications of Kawasaki disease. We experienced a 25-month-old boy who had high fever and pneumonic consolidation in the right middle and lower lobe of the lung that was considered as mycoplasma pneumonia on admission and developed coronary artery aneurysmal dilatation during treatment with roxythromycin.

우리나라에서는 아직 마이코플라스마 폐렴이 가와사키병에 병발한 경우가 보고된 적이 없으며 마이코플라스마 폐렴의 특성상 다양한 호흡기 외의 증상이 비교적 흔하게 동반되는 점 등을 고려할 때, 적절한 치료에도 불구하고 지속되는 발열을 보이는 마이코플라스마 폐렴의 경우 반드시 비전형적 가와사키병이 감별되어야 할 것이며, 이미 언급한 바와 같이 초항원(superantigen)에 근거해 가와사키병의 병태생리를 규명하고자 하는 연구들을 지지할 수 있는 또 하나의 근거로 생각되어 본 증례를 보고하는 바이다.

Keywords

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