Her skin is notable for a fine, erythematous, maculopapular rash on the face, chest, back, and extremities. Her extremities are warm, well perfused, and without swelling. Her abdomen is soft and mildly tender to palpation throughout, with no hepatosplenomegaly. Her lungs are clear to auscultation, and the cardiovascular examination reveals tachycardia without murmurs. Her eyes are injected bilaterally, without purulent discharge. She is tachycardic, with a heart rate of 166 beats/min and tachypneic, with a respiratory rate of 48 breaths/min. Her temperature at triage is 39.8☌ (103.6☏). On physical examination, the child appears tired and ill, although she is not in distress. She attends a small, in-home daycare, but none of the other children there have been sick. The child was previously healthy, with no prior hospitalizations, and she is fully immunized. The remainder of the review of systems is negative. The mother has not noticed swelling of the extremities or peeling skin. Today, the child was noted to have red eyes, without discharge, and redness in the genital area. Her lips are cracked, and her mother attributes this to poor oral intake over the past few days. Her mother reports the subsequent development of a red rash that started on the child’s face and chest, and it is now present on her trunk, back, and extremities. She was evaluated at her pediatrician’s office 2 days ago, and she was diagnosed with a viral illness. She has been complaining of abdominal pain and had 2 episodes of nonbilious vomiting in the last 2 days. The child has some rhinorrhea, but no significant cough. Her mother reports that the child has had a fever for the past 5 days, with temperatures ranging from 38.3☌ (101☏) to 40☌ (104☏). Case PresentationĪ 3-year-old girl presents to the emergency department for evaluation of fever. Emergency clinicians should consider Kawasaki disease as a diagnosis in pediatric patients presenting with prolonged fever, as prompt evaluation and management can significantly decrease the risk of serious cardiac sequelae. This issue reviews the presentation, diagnostic criteria, and management of Kawasaki disease in the emergency department. At this time, the etiology of the disease remains unknown, and there is no single diagnostic test to confirm the diagnosis. Because each of the symptoms commonly occurs in other childhood illnesses, the disease can be difficult to diagnose, especially in children who present with an incomplete form of the disease.
#SHOTTY CERVICAL LYMPHADENOPATHY PLUS#
This vasculitis presents with fever for ≥ 5 days, plus a combination of key criteria. Untreated Kawasaki disease may lead to the formation of coronary artery aneurysms and sudden cardiac death in children. It is currently the leading cause of acquired heart disease in children in the United States. Kawasaki disease, also known as mucocutaneous lymph node syndrome, was first described in Japan in 1967. American Academy Of Pediatrics Risk Stratification And Recommendations On Follow Upįigure 2. Comparison Of Kawasaki Disease And Other Similarly Presenting Diseases Differential Diagnosis Of Prolonged Fever In Pediatric Patients Risk Management Pitfalls In Kawasaki Disease.Epidemiology, Etiology, And PathophysiologyĬlinical Pathway For Emergency Department Management Of Kawasaki Disease
0 kommentar(er)
