International Journal of Surgical Wound Care
Online ISSN : 2435-2128
Case Reports
A Case of Kawasaki Disease That Developed During the Treatment of Scalds
Makoto ShimabukuroYumiko Uchikawa-TaniKayoko UnoKazumi MorisawaTsutomu TakahashiNaohiro Ishii
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2022 Volume 3 Issue 4 Pages 126-131

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Abstract

Kawasaki disease (KD) is a systemic vasculitis syndrome with a predisposition for infants under four years of age, the cause of which remains unclear. A few cases of KD have been reported in infants undergoing burn treatment. Although toxic shock syndrome toxin-1 (TSST-1) produced by Staphylococcus aureus at the wound site is thought to be involved in the pathogenesis of KD, no case has been reported in which Staphylococcus aureus detected at the wound site was confirmed to be a non-producer of TSST-1. In this study, we report the first case of KD that developed during the treatment of a burn wound, in which the involvement of TSST-1 was ruled out. The patient was an 11-month-old male infant. The patient was admitted to the hospital on the same day of a second-degree burn injury, with a burn area of 10.5% due to exposure to boiling water. The patient was diagnosed with KD and was started on treatment with aspirin and immunoglobulin. Methicillin-resistant Staphylococcus aureus was detected in the wound, TSST-1 production was negative, and the neonatal toxic shock syndrome–like exanthematous disease (NTED) index was low. The patient’s symptoms improved after the start of treatment, and he was discharged from the hospital on the 18th day. Although damage-associated molecular patterns (DAMPs) are considered as a possible cause of the onset of the disease, we were not able to measure them, and this is an issue for the future.

Relationship between the burn area and number of days to KD onset. Fullsize Image
correlation coefficient: 0.61
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© Japan Society for Surgical Wound Care 2022
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