It's not Just Growing Pains: A Guide to Childhood Muscle, Bone, and Joint Pain, Rheumatic Diseases, and the Latest Treatments

By Thomas J. A. Lehman | Go to book overview

17
Kawasaki Disease

Billy was a three-year-old boy who had always been in good health.
Ten days before he was sent to my office, his mother noted that he
appeared irritable. He had a low-grade fever and the next day he was
taken to the pediatrician to be checked for an ear infection. The pe-
diatrician noted that he had conjunctivitis (red, irritated eyes) and gave
the mother drops. The pediatrician explained this was probably the
result of a viral infection. Over the next two days Billy remained irri-
table. Although his eyes got better, his fever continued.

His mother noted a tender lump under his chin. She brought him
back to the pediatrician. The pediatrician diagnosed cervical adenitis
(an infection of a lymph gland in the neck area). Billy was started on
antibiotics. He developed a rash the next day and the antibiotic was
changed because he was possibly allergic. Three days later the mother
returned to the pediatrician because Billy was not getting better. He still
had fever; the tender lump under his chin was getting larger. Now his
lips were dry and beginning to split. His tongue was red and irritated.

The pediatrician ordered laboratory tests and the white blood cell
(WBC) count, erythrocyte sedimentation rate (ESR), and platelet count
were all very high. Billy was sent to me and the diagnosis of Kawasaki
disease was confirmed. He was treated with intravenous gamma-
globulin (IVIgG) and his symptoms disappeared promptly. We moni-
tored his heart and there was no sign of heart involvement. Billy
recovered completely.


Things you need to know
Kawasaki disease (KD) most often affects young children (mostly under the age of five years) and the diagnosis should be carefully questioned in anyone over the age of ten.

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