Assuntos
Toxoide Diftérico , Difteria/diagnóstico , Asma/complicações , Pré-Escolar , Contraindicações , Difteria/terapia , Evolução Fatal , Humanos , Madagáscar , Masculino , Erros MédicosRESUMO
Kawasaki disease is recognized as a leading cause of acquired heart disease in some Western countries. It has rarely been described in Africa. The purpose of this report is to describe a case of typical Kawasaki disease in a 9-year-old girl from Madagascar. Despite administration of acetylsalicylic acid upon admission (80 mg/kg/d), the patient developed pancarditis on day 6 that was complicated by acute left heart failure confirmed by echocardiography. A clearcut improvement was obtained using prednisone (2 mg/kg/day) before treatment using intravenous immunoglobulins imported from France on day 11 (0.5 mg/kg/day for 5 days). Echocardiography on day 24 demonstrated a 5 mm aneurysm in the left coronary artery. Acetylsalicylic acid was discontinued at 6 months after control examinations at 4 and 6 months demonstrated disappearance of the aneurysm. In addition to further documenting the presence of Kawasaki disease in Madagascar, this case report illustrates the difficulty of management in a developing country.