PMC7641693_01
Inguinal lymphadenitis with cellulitis. (a) At admission., skin erythema was observed in the left inguinal area. (b) Before intravenous immunoglobulin treatment, inguinal cellulitis expanded to the entire lower abdomen. (c) After treatment, lamellar desquamation of the left inguinal region was observed.
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Physical examination on admission revealed left inguinal lymphadenitis with adjacent cellulitis (Figure 1(a)). However, the cellulitis had spread over the entire lower abdomen, which seemed atypical for KD (Figure 1(b)). The cellulitis also improved gradually, and she had lamellar desquamation of the left inguinal region on day 11 (Figure 1(c)).
Clinical course. IL, interleukin; IVIG, intravenous immunoglobulin; PSL, prednisolone; sTNFR, soluble tumor necrosis factor receptor.
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Her clinical course is shown in Figure 2. This pattern is consistent with that of KD (Figure 4) and was sustained until the initiation of IVIG and PSL (Figures 2 and 4).
Enhanced computed tomography findings. A pelvic enhanced computed tomography scan showing an enlarged left inguinal lymph node (white arrow, approximately 1.5 x 1.0 cm), densification, and thickening of the regional soft tissue without abscess.
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However, the increased number and size of lymph nodes and densification and thickening of the subcutaneous soft tissue in the left inguinal region on an enhanced CT scan were strongly suggestive of cellulitis (Figure 3).
Serum cytokine profiles. (a) At admission. (b) Before intravenous immunoglobulin treatment. (c) Typical KD patients (N = 64). Overlaid inner yellow pentagons in the chart of KD patients show the mean values of healthy controls. IL, Interleukin; KD, Kawasaki disease; sTNFR, soluble tumor necrosis factor receptor.
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This pattern is consistent with that of KD (Figure 4) and was sustained until the initiation of IVIG and PSL (Figures 2 and 4).