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Bacteriuria With CTX-M-8 Extended-Spectrum β-Lactamase–Producing Escherichia coli in a Patient With Incomplete Kawasaki Disease

We report the case of a 2-month-old infant with incomplete Kawasaki disease that presented as an apparent urinary tract infection. The patient’s fever persisted despite antibiotic treatment. Intravenous immunoglobulin and aspirin therapy cured both the incomplete Kawasaki disease and bacterial pyuri...

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Detalles Bibliográficos
Autores principales: Kamijo, Kaori, Abe, Yoshifusa, Kagami, Takehi, Ugajin, Kazuhisa, Mikawa, Takeshi, Fukuchi, Kunihiko, Tatsuno, Masaru, Itabashi, Kazuo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6328953/
https://www.ncbi.nlm.nih.gov/pubmed/30671497
http://dx.doi.org/10.1177/2333794X18821944
Descripción
Sumario:We report the case of a 2-month-old infant with incomplete Kawasaki disease that presented as an apparent urinary tract infection. The patient’s fever persisted despite antibiotic treatment. Intravenous immunoglobulin and aspirin therapy cured both the incomplete Kawasaki disease and bacterial pyuria. Renal sonography, voiding cystourethrography, and renal parenchyma radionuclide scanning did not detect any abnormalities. Temporary dilation of the coronary artery was noted. In a urine specimen obtained through transurethral catheterization, the growth of 10(5) colony-forming units/mL of extended-spectrum β-lactamase–producing Escherichia coli was detected. Polymerase chain reaction analysis revealed that the enzyme genotype was CTX-M-8, which is a rare type in Japan. In conclusion, attention should be paid to a misleading initial presentation of fever and pyuria, which might be interpreted as urinary tract infection in patients with Kawasaki disease. Furthermore, pediatricians should consider incomplete Kawasaki disease when patients present with fever and pyuria, which are consistent with urinary tract infection, but do not respond to antibiotic treatment.