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Abstract

Kawasaki disease (KD) is a multi-systemic vasculitis of pediatric age group. Early diagnosis and treatment is crucial as coronary artery aneurysms may develop in 20-25% of untreated cases in the 2nd -3rd weeks of the disease. The most common urinary finding in the active period is sterile pyuria; which is believed to be a sign of a more severe systemic inflammation. In this study, a 3.5 year old boy who admitted with high fever was presented. As he had pyuria and elevated acute phase reactants, antibiotic treatment was started with a pre-diagnosis of acute pyelonephritis. Later, with the persistence of fever, detection of a negative urine culture result and emergence of dermal, mucosal and conjunctival changes, incomplete KD was diagnosed. In conclusion, it should be remembered that prolonged fever with sterile pyuria can be the initial findings in KD; before the emergence of typical lesions

Keywords

• Kawasaki disease, sterile pyuria, pediatric age group

İlk bulgusu steril piyüri olan bir Kawasaki hastalığı olgusu

Abstract

Kawasaki hastalığı çocukluk çağı multisistemik vaskülitidir. Tedavi edilmemiş olan olguların %20-25 inde hastalığın ilk 2-3. haftasında koroner arter anevrizması gelişebileceğinden erken tanı ve tedavi önem taşır. Steril piyüri hastalığın aktif döneminde en sık görülen idrar bulgusu olup, daha ağır sistemik enflamasyon varlığına işaret eder. Bu çalışmada yüksek ateş nedeniyle başvuran, piyüriyle birlikte akut faz belirteçlerinde yükseklik saptanarak akut piyelonefrit ön tanısıyla antibiyotik tedavisi başlanan, izleminde ateşin sebat etmesi, idrar kültüründe üreme olmaması ve cilt, mukoza ve konjunktiva değişiklerinin ortaya çıkmasıyla inkomplet Kawasaki hastalığı (KH) tanısı alan 3,5 yaşında bir erkek olgu sunulmuştur. Bu nedenle KH’da uzamış ateşle birlikte steril piyürinin hastalık için tipik belirtiler henüz ortaya çıkmadan ilk başvuru bulgusu olabileceği de akılda tutulmalıdır.

Anahtar kelimeler: Kawasaki hastalığı, steri piyüri, çocukluk yaş grubu

Keywords

• Kawasaki hastalığı, steri piyüri, çocukluk yaş grubu

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