日本紅斑熱

・川崎病と鑑別困難だった小児の日本紅斑熱を経験した． （「症例のポイント」より）

A case of Japanese spotted fever

Okuno, Aika1）Hinoue, Atsushi2）Suga, Takenori3） 1）Department of Dermatology, Takatsuki Red Cross Hospital 2）Hinoue Dermatorogy and Plastic Surgery Clinic 3）Department of pediatric emergency and critical medicine, Hyogo Prefectural Amagasaki General Medical Center

Abstract We report a case of Japanese spotted fever in a 9 year-old girl. Since her clinical symptoms were similar to Kawasaki disease, it was difficult to diagnose. This case showed hyperthermia, lymph node swelling persisted, ocular conjunctiva hyperemia in the eyeball, lip redness, rigid edema in both hands palm which were common symptoms of Kawasaki disease. At the time of admission, there was also information that grandmother living in Awaji was diagnosed with the same symptoms and Japanese spotted fever at the same time, and once the skin was confirmed from the head again, a scab portion of 5 mm was found at the top of the head. The results of blood DNA (PCR method) showed that Japanese spotted fever was negative, but the serum Rickettsia japonica IgM antibody titer increased and the IgG antibody titer increased by 40 times or more as compared with the recovery period in the pair serum , we diagnosed this case as Japanese spotted fever. Even in the case of fever, erythema and lymph node swelling cases suspected of Kawasaki disease, if the residence is an endemic area, it is necessary to keep in mind the Japanese spotted fever.