kawasaki disease Flashcards
what is kawasaki
self limiting condition
fever and manifestations of acute inflammation lasting 12 days without therapy
early treatment required to prevent complications
complications of kawasaki
coronary artery synndromes - infants under 12 months are at increased risk of coronary artery aneurysm
depressed myocardial contractility and heart failure
myocardial infarction
arrythmias
peripheral arterial occlusion
diagnosis
clinical
pressence of prolonged fevr lasting more than 5 days with at least 4 of the following:
- bilateral non exudative conjunctivitis
- polymorphous rash
- cervical lymphadenopathy
- mucositis (cracked red lips, injected pharynx or strawberry tongue )
- extremity changes - erythema on palms/soles, oedema of hands/feet, periungual desquamation
associated non-specific symptoms of kawasaki disease
diarrhoea, vomiting, abdo pain
irritability
cough or rhinorrhea
joint pain
weakness
incomplete (atypical) kawasaki disease
diagnostic crteria not fulfilled but otherwise similar clinical picture to that of classic kawasaki disease
still at risk of cardiovascular complications
laboritory findings
elevated acute phase reactants (CRP, ESR)
elevated WCC with predominant neutrophilia
elevated platelets
normocytic, normochromic anaemia
sterile pyuria
invesstigations
there are no diagnostic tests for kawasaki disease but can be supportive orr used to exclude other caauses of fever
CPR, ESR, FBC, ALT, Albumin
AASOT/antiDNAase B
urinalysis
blood culture
differential diagnosis
adenovirus
EBV
carlett fever
toxic shock syndrome
steven - johnson syndrome
measles
initial management
IV immunoglobulin IVIG
low gose aspirin
further management
second dose IVIG may be given is incomplete treatment response, particulalry in high risk age group and atypical kawasaki disease
refer to cardiology for echocardiogram and reppeat echo at 4-8 weeks post treatment
