Daily bolus of LR: Kawasaki disease

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February 7, 2011 by dailybolusoflr

Kawasaki disease is an acute, self limited vasculitis that occurs in infants and young children.
·         Peak age is 18-24 months with majority of children under age 4
·         Boys > girls
·         Etiology unknown, but possibly related to infectious or host immune response to an infection
 
Presentation is characterized by:
·         fever
·         conjunctivitis
·         rash (often starting on perineum and spreading to torso)
·         erythema of the oral mucosa and lips (cracked lips and strawberry tongue)
·         swelling of the extremities
·         cervical lymphadenopathy
 
Major concern is CARDIAC effects:
 
·         Approximately 15–25% of untreated children develop coronary artery aneurysms, which may result in myocardial infarction and ischemic heart disease.
·         Myocarditis is a common feature early in the course of the disease and in severe cases.
·         Kawasaki disease has surpassed acute rheumatic fever as the leading cause of acquired heart disease in children.
·         ECG findings in these patients can vary from normal to classic changes associated with ischemia and infarction .
 
Treatment is admission with IVIG and high dose aspirin.
 
 
Linda Regan, MD FACEP
Program Director, Emergency Medicine Residency
Johns Hopkins Medical Institutions

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