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:
· 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