reply to post need refences
Carisa posted Nov 3, 2022 9:09 PM
Etiology
The exact cause of Kawasaki disease is still undetermined, but studies have suggested it is easier to catch after a bacterial or viral infection. Genes can play a role in this disease as some children are more likely to get KD compared to others. Factors that contribute to the likelihood of getting this disease would be Age (children under 5), boys (more likely than girls), and Ethnicity (Asian or pacific islander have a higher rate of this disease). Although, it does not mean a patient cannot acquire this disease older than 5 years of age, but it is less likely.
Epidemiology
Kawasaki disease happens worldwide, but it’s more prevalent in Japan compared to other countries. According to the CDC, in a study in the US the incidence of KD ranging from 9 to 20 per 100,000 children under the age of 5 years old(CDC,2020).
Pathophysiology
Kawasaki disease is febrile illness and systemic vasculitis syndrome and firstly penetrates coronary arteries that can lead to myocardial infarction or ischaemic heart disease. Although there isn’t enough data to identify the direct cause; there is a correlation within infections prior to the diagnosis of KD.
Clinical manifestation
Fever
Rash
Swelling of hands and feet
Inflammation of the mouth lips and tongue (strawberry tongue)
Swollen lymph glands in the neck
Redness of the clear of the eyes
Work up
LABS
CBC complete blood count
Elevated white blood cells
Hemoglobin and hematocrit (typically anemic)
Renal functions ( dehydration)
Liver enzymes
albumin
ESR ( elevated)
CRP c reactive protein (elevated)
UA- urinalysis (typically pyuria)
Strep test – to rule out strep
Electrocardiogram- measure electrical impulse of the heartbeat. (KD can cause abnormal heart rhythms)
Echocardiogram- Ultrasound imaging to show the effectiveness of the heart is pumping and identify any issues within the coronary arteries.
Nonpharmacological management
Typically the child will be hospitalized so rest is important.
Stuff animals or toys to make the child feel better.
Picture books
Blowing bubbles
Listening to music
Watching cartoons
Pharmacological management
IV treatment to reduce inflammation of the vessels called gamma globulin(2g/kg)
Aspirin- high doses (80 to 100 mg/kg/day) of aspirin will help with inflammation and can also help with joint inflammation, pain, and fever. Normally children wouldn’t be given aspirin since it’s been linked to reye’s syndrome, but in life threatening moments such as KD this is needed(Darby, 2021).
Increase hydration.
Education
This is a life threatening disease and so if you suspect any child has this, it is imperative that the child must go to a hospital for care.
Typically a child is hospitalized 2-5 days
Hydration is important due to lack of appetite, vomiting and dehydration.
Kawasaki disease is not contagious.
The disease was first found in Japan in 1967 by a Japanese pediatrician named Tomisaku Kawasaki(Darby, 2021).
Follow up:
After the patient has been discharged from the hospital the patient should be seen by their primary care physician within two weeks.
The patient should be seen by a cardiologist after discharge as well.
References:
Centers for Disease Control and Prevention. (2020, May 29). About kawasaki disease. Centers for Disease Control and Prevention. Retrieved November 3, 2022, from https://www.cdc.gov/kawasaki/about.html
Darby, J. B., & Jackson, J. M. (2021, August 31). Kawasaki disease and multisystem inflammatory syndrome in children: An overview and comparison. American Family Physician. Retrieved Novembaqwer 3, 2022, from https://www.aafp.org/pubs/afp/issues/2021/0900/p244.html
