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KMID : 0367419780190040065
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Journal of Korean Pediatric Society
1978 Volume.19 No. 4 p.65 ~ p.70
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Infantile acute febrile Mucocutaneous Lymph Node Syndrome
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高炯基/Ko, Hyung Ki
林泰赫/安敦姬/孫槿贊/Yim, Tai Hyuk/Ahn, Don Hee/Sohn, Keun Chan
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Abstract
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Infantile acute febrile Mucocutaneous lymph node syndrome was first described as a new clinical entity by Kawasaki in Japan in 1967. It is characterized by fever, conjunctival congestion, reddening of lips and oral cavity, strawberry like tongue and accompanied by non-suppurative swelling of cervical lymph nodes. The author insisted that this entity was quite distinct from erythema multiforme, infantile periarteritis nodosa, Stevens-Johnson syndrome and scarlet fever in many ways. Since then, nearly 7.000 cases were reported in Japan until 1975. In Korea 8 cases were reported in 1973. There have been also 12 case reports from Hawaii, 3 from continental United States and 8 from Greece.
We experienced 2 cases of such patients in 3 year nld boy and 11 months old female i.ifaat respectively. Their clinical symptoms, laboratory data and clinical courses were presented comparing to originanal article with brief review of other literatures.
Case I . A 3 year old, Korean male admitted due to high fever and skin rash. One day PTA, he suffered from abdominal pain. In the morning of admission day, skin rash began to appear on the distal part of extremities. Past and family history were not contributory. Vital signs showed BT 39.2C and pulse 168/min. On physical exam, erythematous polymorphous maculopapular skin rash cn the whole body, congested conjunctiva, dry and reddened lips, protruded tongue nalillae and right cervical lymphnode enlargement were iioted. Mild jaundice anti diarrhea wer, also noted. Lab. findings showed Hb 11. 1 gm%. ESE 28, WBC 1530i7(Band neut 41,1,j, Seg neut 485%, Lympho 5%, Mono 3%, Metamyelocvte 3%) and mild proteinuria. Throat swab culture, blood, urine and stool culture were negative. Chest X-ray was negative. On the 7 th day of i´lness, skin rash was almostly subsided and membranous desquamation noted on 13 th day of illness.
Case II . An eleven months old, Korean female admitted due zo fever and rash. 4 days PTA, he was noted h:oh fever, followed by swelling of bilateral cervical regio,z. 2 day- PTA, s´~=r. rashes were noted at post auricular area and ..ps became dry and reddened. Past histery
showed that she was prone to catch cold. Vital signs were BT 39.7C and pulse 124/min. On physical exam, erythematous polymorphous maculopapular skin rashes were noted on the ole body. Lips were dry, reddish and fissuring. Walnut sized bilateral cervical lymphnodf , Fr
palpable. Palms and soles were reddened with indurative edema. Laboratory findings ed, Hb 13.3 WBC 31500 (Seg neut 515%5, lympho 28%, banded neut 12%, mono 6%) and
Throat swab culture and urinalysis were negative. AST was 20. Electrophoresis ed increased alpha-2 globulins. On the Ist week of illness, fever and indurative edema of were almostly subsided. On the 10 th day of illness, skin rashes were also almostly disapFY On the 12 th day of illness, desquamation of skin was noted.
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