Korean J Pediatr.  2009 Sep;52(9):1029-1034. 10.3345/kjp.2009.52.9.1029.

A case of adolescent Kawasaki disease with Epstein-Barr virus-associated infectious mononucleosis complicated by splenic infarction

• Choi BS
• Kwon BS
• Kim GB
• Jeon YK
• Cheon JE
• Bae EJ
• Noh CI
• Choi JY
• Yun YS

• KMID: 2281259
• DOI: http://doi.org/10.3345/kjp.2009.52.9.1029

Abstract

Kawasaki disease (KD) is an acute systemic vasculitis of unknown etiology that affects children. There are few reports that describe the Epstein-Barr virus (EBV) as the possible infectious agent of KD. Here, we describe a case of KD in a 15-year-old boy complicated with giant coronary artery aneurysms, pericardial effusion, and splenic infarction. The clinical course of KD was refractory to intravenous gamma globulin and aspirin. Our patient also showed typical findings of concomitant EBV-associated infectious mononucleosis, such as hepatosplenomegaly and generalized lymphadenopathy, with EBV-positive atypical lymphoid hyperplasia. He improved dramatically after receiving intravenous methylprednisolone followed by oral prednisolone. Ultimately, the coronary artery aneurysms remained as the only sequelae. We report a rare case of adolescent KD with EBV-associated infectious mononucleosis and splenic infarction.

Keyword

Mucocutaneous lymph node syndrome; Epstein-Barr virus infection; Coronary artery disease; Splenic infarction; Corticosteroids

MeSH Terms

Adolescent
Adrenal Cortex Hormones
Aneurysm
Aspirin
Child
Coronary Artery Disease
Coronary Vessels
gamma-Globulins
Herpesvirus 4, Human
Humans
Hyperplasia
Infectious Mononucleosis
Lymphatic Diseases
Methylprednisolone
Mucocutaneous Lymph Node Syndrome
Pericardial Effusion
Prednisolone
Splenic Infarction
Systemic Vasculitis
Adrenal Cortex Hormones
Aspirin
Methylprednisolone
Prednisolone
gamma-Globulins