Korean J Pediatr Infect Dis.  2014 Dec;21(3):225-230. 10.14776/kjpid.2014.21.3.225.

Gram-negative Septicemia after Infliximab Treatment in an Infant with Refractory Kawasaki Disease

• Lee JH
• Yoon JM
• Lim JW
• Ko KO
• Cheon EJ

• KMID: 2279100
• DOI: http://doi.org/10.14776/kjpid.2014.21.3.225

Abstract

Kawasaki disease (KD) is an immune-mediated disease which is a leading cause of acquired cardiovascular disease in developed country. Recently, tumor necrosis factor-alpha (TNF-alpha) blocker, infliximab has been considered a promising option for patients with refractory KD. Although chronic use of a TNF-alpha blocker could increase risk of opportunistic infections, a few studies have documented that use of infliximab was safe without serious adverse effects in patients with KD. We observed serious bacterial infection after infliximab treatment in an infant with refractory KD. Our patient was a 5-month-old male infant diagnosed with KD who did not respond to repeated doses of intravenous immunoglobulin. We effectively treated him with a single infusion of infliximab (5 mg/kg), but gram-negative (Acinetobacter lwoffii) septicemia developed after infliximab infusion. Therefore, we report a case of serious septicemia after treatment with infliximab, and suggest considering the risk of severe infection when deciding whether to prescribe infliximab to an infant with refractory KD.

Keyword

Kawasaki disease; Tumor necrosis factor-alpha; Infliximab; Septicemia

MeSH Terms

Bacterial Infections
Cardiovascular Diseases
Developed Countries
Humans
Immunoglobulins
Infant*
Male
Mucocutaneous Lymph Node Syndrome*
Opportunistic Infections
Sepsis*
Tumor Necrosis Factor-alpha
Infliximab
Immunoglobulins
Tumor Necrosis Factor-alpha

Figure

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  Fig. 1. Changes in the body temperature and the types of interventions used during the hospital course.

Reference

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