All issues > Volume 52(9); 2009

Case Report

Korean J Pediatr. 2009;52(9):1029-1034. Published online September 15, 2009.

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

Byeong Sam BS Choi¹, Bo Sang BS Kwon¹, Gi Beom GB Kim¹, Yoon Kyung YK Jeon², Jung-Eun JE Cheon³, Eun Jung EJ Bae¹, Chung Il CI Noh¹, Jung Yun JY Choi¹, Yong Soo YS Yun¹

¹Departments of Pediatrics, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Korea
²Departments of Pathology, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Korea
³Departments of Radiology, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Korea

Correspondence Eun Jung EJ Bae ,Email: eunjbaek@snu.ac.kr

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.

Keywords :Mucocutaneous lymph node syndrome, Epstein-Barr virus infection, Coronary artery disease, Splenic infarction, Corticosteroids