Lightning Learning: Kawasaki Disease
Kawasaki Disease is a vasculitis affecting medium-sized arteries.
Emergency clinicians should consider Kawasaki disease in kids with prolonged fever, as prompt management significantly decreases the risk of serious cardiac sequelae.
Diagnostic criteria: 5-day fever PLUS four of the following…
Cervical lymph node >1.5cm
Cracked lips/strawberry tongue
Erythema/oedema/peeling of the hands/feet
Other features include BCG scar inflammation, raised CRP and irritability without CNS infection.
Beware: diagnosis can be made before Day 5 of fever if clinical signs suggestive. Also if just 2-3 criteria present, consider incomplete Kawasaki.
Kawasaki Disease is the leading cause of acquired heart disease in the developed world. It affects children under the age of 6 years old with severe disease often associated with children under 1 year old. Treatment is with high-dose aspirin, IV immunoglobulin & PPI.
Coronary aneurysms (causing thrombosis, MI and tamponade)
Bleeding (due to aspirin)
Consider echo EARLY in diagnosis!