Kawasaki Disease

Background

  • Idiopathic, self-limiting vasculitis predominantly seen in children under 5.
    • More common in Asian populations
    • Still uncommon (8/100,000)- although potentially serious (see complications)

Features

  • Classical
    • Fever >5 days (usually high-grade and paracetamol resistant)
    • Marked irritability
    • Erythema, swelling and desquamation affecting the skin of the extremities
    • Bilateral conjunctivitis
    • Rash
    • Inflammation of the lips, mouth and/or tongue (strawberry tongue)
    • Cervical lymphadenopathy
  • Symptoms can gradually improve over several weeks

Investigations

  • Clinical diagnosis (often quite apparent) but generic investigations including FBC, LFT and U&Es can be included as part of the workup to exclude infection and other causes)
  • Echocardiogram is important to screen for coronary aneurysms, which can increase the risk of myocardial infarction and acute coronary syndromes

Management

  • Aspirin (high dose)
    • NB ASPIRIN IS NOT ROUTINELY RECOMMENDED FOR USE IN CHILDREN DUE TO RISK OF REYE’S SYNDROME.  ONLY GIVE ASPIRIN IF DIAGNOSIS IS CLEAR
  • IVIg
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