Late Onset Sepsis and Incomplete Kawasaki Disease in a 3-Month-Old Infant: A Case Report and Literature Review

Abstract

Despite advances in the antimicrobial therapy and implementation of a multitude of screening protocols, group B streptococcus (GBS) infection remains a major cause of morbidity and mortality in newborns and young infants. The incidence of GBS septicemia, however, declines drastically with age, and it is rarely implicated as a cause of sepsis in infants older than 2 months. Recently we were involved in caring for a female infant from Brooklyn who presented with subtle signs of infection and her blood culture later grew GBS. She also had significant coronary artery dilatation suggestive of another ongoing inflammatory process which could not be justified solely by a GBS infection. Kawasaki disease (KD) is an acute febrile illness of childhood characterized by self-limited vasculitis and is known to cause coronary artery changes if not treated timely. The first case of this unusual illness was observed by Tomisaku Kawasaki in 1961 in a 4-year-old child who presented with an unremitting fever and a rash. Even though five decades have passed, no laboratory gold standard is available and like all clinical entities which are diagnosed exclusively by presence of clinical signs, KD too is vulnerable to underestimation depending upon the specificity of signs used for its identification.




Int J Clin Pediatr. 2014;3(2):51-54
doi: http://dx.doi.org/10.14740/ijcp147w