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VOLUME 5 , ISSUE 3 ( July-September, 2023 ) > List of Articles
Keerthana Menon, Swati Narasimhan, Shruthi Natarajan, Padmasani V Ramanan
Keywords : Immunization, Incomplete Kawasaki disease, Pneumococcal infection
Citation Information : Menon K, Narasimhan S, Natarajan S, Ramanan PV. A Case Report on Pneumococcal Sepsis with Incomplete Kawasaki Disease. Pediatr Inf Dis 2023; 5 (3):93-99.
License: CC BY-NC 4.0
Published Online: 29-09-2023
Copyright Statement: Copyright © 2023; The Author(s).
Background: Kawasaki disease (KD) is a multisystem vasculitis which occurs due to various infectious triggers causing an abnormal immunological response. There are very few case reports on KD with pneumococcal infection. We report a case of pneumococcal sepsis associated with KD. Case description: A 11-month-old girl was referred to our hospital with a history of fever and cough for 10 days and one episode of seizure on day 1 of fever. She had not been immunized with the pneumococcal conjugate vaccine (PCV). On examination, she was irritable and tachypneic and had crepitations on the left infrascapular and infra-axillary regions on auscultation. A diagnosis of pneumonia was made. Chest X-ray revealed left lobar consolidation. Blood culture showed Streptococcus pneumoniae 19A growth. In view of the history of seizures and the child's irritability, an magnetic resonance imaging (MRI) brain with contrast was done to rule out intracranial infection and was found to be normal. In view of persistent fever, no response to antibiotics, marked irritability, and investigations showing leukocytosis, anemia, thrombocytosis, elevated inflammatory markers, incomplete KD was suspected. Echocardiogram (ECHO) showed left main coronary artery dilatation. She was treated with intravenous immunoglobulin (Ig) and aspirin. The fever resolved within 24 hours, and the child became playful. She was discharged on oral amoxicillin and aspirin. Clinical significance: We emphasize the need for pneumococcal vaccination (PCV13) for all children to prevent infection and infection-triggered complications.