Association of Yersinia Infection With Kawasaki Disease: A Prospective Multicenter Cohort Study.
Journal
The Pediatric infectious disease journal
ISSN: 1532-0987
Titre abrégé: Pediatr Infect Dis J
Pays: United States
ID NLM: 8701858
Informations de publication
Date de publication:
01 Dec 2023
01 Dec 2023
Historique:
medline:
16
11
2023
pubmed:
19
9
2023
entrez:
19
9
2023
Statut:
ppublish
Résumé
Yersinia infection is known to present with Kawasaki disease (KD)-like symptoms although differentiating the 2 has been a challenge. The present study aimed to describe the clinical characteristics and prevalence of Yersinia infection presenting with KD-like symptoms. The present, prospective, multicenter study enrolled patients who received a diagnosis of KD between January 2021 and January 2022 at 2 hospitals in Tokyo. Stool samples were collected within 3 days of the start of KD treatment, and cultures were performed for Yersinia . Clinical history and symptoms suggestive of Yersinia infection were also evaluated. During the study period, 141 KD patients were screened and 117 patients with evaluable stool samples were registered. Only 1 patient was positive for Yersinia pseudotuberculosis , which was detected from both stool and blood cultures. The patient was refractory to KD treatment but improved after initiation of appropriate antibiotic therapy. Routine screening for Yersinia is not appropriate for patients with KD and should be limited to certain patients in high-risk areas and those who are refractory to the standard KD treatment.
Sections du résumé
BACKGROUND
BACKGROUND
Yersinia infection is known to present with Kawasaki disease (KD)-like symptoms although differentiating the 2 has been a challenge. The present study aimed to describe the clinical characteristics and prevalence of Yersinia infection presenting with KD-like symptoms.
METHODS
METHODS
The present, prospective, multicenter study enrolled patients who received a diagnosis of KD between January 2021 and January 2022 at 2 hospitals in Tokyo. Stool samples were collected within 3 days of the start of KD treatment, and cultures were performed for Yersinia . Clinical history and symptoms suggestive of Yersinia infection were also evaluated.
RESULTS
RESULTS
During the study period, 141 KD patients were screened and 117 patients with evaluable stool samples were registered. Only 1 patient was positive for Yersinia pseudotuberculosis , which was detected from both stool and blood cultures. The patient was refractory to KD treatment but improved after initiation of appropriate antibiotic therapy.
CONCLUSIONS
CONCLUSIONS
Routine screening for Yersinia is not appropriate for patients with KD and should be limited to certain patients in high-risk areas and those who are refractory to the standard KD treatment.
Identifiants
pubmed: 37725804
doi: 10.1097/INF.0000000000004084
pii: 00006454-202312000-00003
doi:
Types de publication
Multicenter Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1041-1044Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors have no funding or conflicts of interest to disclose.
Références
McCrindle BW, Rowley AH, Newburger JW, et al.; American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young; Council on Cardiovascular and Stroke Nursing; Council on Cardiovascular Surgery and Anesthesia; and Council on Epidemiology and Prevention. Diagnosis, treatment, and long-term management of Kawasaki disease: a scientific statement for health professionals from the American Heart Association. Circulation. 2017;135:e927–e999.
Galindo CL, Rosenzweig JA, Kirtley ML, et al. Pathogenesis of Y. enterocolitica and Y. pseudotuberculosis in human yersiniosis. J Pathog. 2011;2011:182051.
Konishi N, Baba K, Abe J, et al. A case of Kawasaki disease with coronary artery aneurysms documenting Yersinia pseudotuberculosis infection. Acta Paediatr. 1997;86:661–664.
Horinouchi T, Nozu K, Hamahira K, et al. Yersinia pseudotuberculosis infection in Kawasaki disease and its clinical characteristics. BMC Pediatr. 2015;15:177.
Feeney CC, Ajagbe OA, Suryadevara M. Yersinia enterocolitica infection presenting as incomplete Kawasaki disease: 2 cases and a review of the literature. J Pediatric Infect Dis Soc. 2021;10:217–219.
Haidar-Alame S, Raudszus A, Sahai S, et al. A child with Kawasaki disease and Yersinia enterocolitica infection. Glob Pediatr Health. 2015;2:2333794X1559156–233379415591563.
Ohnishi T, Sato S, Kinoshita K, et al. Case of intravenous immunoglobulin-resistant Kawasaki disease with Yersinia enterocolitica enterocolitis successfully treated with cefotaxime following infliximab and cyclosporine. J Pediatric Infect Dis Soc. 2021;10:225–226.
Hassan SM, Doolittle BR. A case of Yersinia enterocolitica mimicking Kawasaki disease. Rheumatology (Oxford). 2009;48:857–858.
Hayashi H, Uda K, Akamine K, et al. A 15-month-old boy with Kawasaki disease-like symptoms. Pediatr Infect Dis J. 2020;40:173–174.
Alfakeekh K, Azar M, Sowailmi BA, et al. Immunosuppressive burden and risk factors of infection in primary childhood nephrotic syndrome. J Infect Public Health. 2019;12:90–94.
Murdaca G, Spanò F, Contatore M, et al. Infection risk associated with anti-TNF-α agents: a review. Expert Opin Drug Saf. 2015;14:571–582.
Suzuki H, Terai M, Hamada H, et al. Cyclosporin a treatment for Kawasaki disease refractory to initial and additional intravenous immunoglobulin. Pediatr Infect Dis J. 2011;30:871–876.
Kobayashi T, Ayusawa M, Suzuki H, et al. Revision of diagnostic guidelines for Kawasaki disease (6th revised edition). Pediatr Int. 2020;62:1135–1138.
Tsubokura M, Otsuki K, Sato K, et al. [Distribution of Yersinia pseudotuberculosis in Japan and epidemiology of human infection]. Kansenshogaku Zasshi. 1987;61:737–745.
Fukushima H. Epidemiology of pathogenic Yersinia and their detection method. Japan J Food Microbiol. 2011;28:104–113.
Tsubokura M, Otsuki K, Sato K, et al. Special features of distribution of Yersinia pseudotuberculosis in Japan. J Clin Microbiol. 1989;27:790–791.
Colomba C, La Placa S, Saporito L, et al. Intestinal involvement in Kawasaki disease. J Pediatr. 2018;202:186–193.
Baker AL, Lu M, Minich LL, et al.; Pediatric Heart Network Investigators. Associated symptoms in the ten days before diagnosis of Kawasaki disease. J Pediatr. 2009;154:592–595.e2.
Yun SH, Yang NR, Park SA. Associated symptoms of Kawasaki disease. Korean Circ J. 2011;41:394–398.