Kawasaki disease

Revision as of 20:50, 22 June 2011 by Jswartz (talk | contribs)

Diagnosis

CDC Definition

  • Fever >5d and 4 of the following:
  1. Rash
  2. Cervical LAD (>1.5cm diam, usually unilat)
  3. Bilateral nonexudative conjunctivitis
  4. Oral mucosal changes
  5. Extremity edema/erythema/desquamation

Associated Sx

  1. Cardiac
    1. Coronary aneurysm
      1. Most develop during 3-4th week of illness
      2. May lead to MI (leading cause of death)
    2. Myo/pericarditis
    3. Pericardial effusion
    4. LV dysnfunction
    5. Valvular dysfunction
    6. Dysrhythmias
  2. Labs
    1. Elevated ESR/WBC/LFTs/Plts
  3. Aseptic meningitis
  4. Urethritis, Anemia
  5. RUQ pain, large GB (hydrops)

Work-Up

  1. CBC/Diff/SPA/ALT/TBili
  2. Blood Cx and UA
  3. ECG
  4. Echo (Coronaries, LV, Valves)
  5. Red Top "Kawasaki Serum to CBR"

Treatment

  1. Immunoglobulin
    1. IVIG 2gm/kg over 12hr
  2. ASA 20mg/kg/dose q6h

Disposition

  1. Cardiology f/u
  2. Cont ASA at high dose
    1. Switch to ASA 3-5mg/kg/day once afebrile x48h

Source

Tintinalli

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