Thursday, January 15, 2009

KAWASAKI DISEASE

What is KAWASAKI DISEASE?

Kawasaki disease is an illness that involves the skin, mouth, and lymph nodes, and most often affects kids under age 5. It was first described in 1967 by Dr. Tomisaku Kawasaki in Japan .Kawasaki disease is predominantly a disease of young children, with 80% of patients younger than 5 years of age. The disease affects boys more than girls. Approximately 2000-4000 cases are identified in the United States each year

The cause is unknown, but if the symptoms are recognized early, kids with Kawasaki disease can fully recover within a few days. Untreated, it can lead to serious complications that can affect the heart.


Conjunctival InjectionStrawbery Toungeswollen lymph nodes



Symptoms


Kawasaki disease often begins with a high and persistent fever that is not very responsive to normal doses of paracetamol (acetaminophen) or ibuprofen. The fever may persist steadily for up to two weeks and is normally accompanied by irritability. Affected children develop red eyes, red mucous membranes in the mouth, red cracked lips, a "strawberry tongue" ,iritis ,keratic precipitates (detectable by an ophthalmologist but usually too small to be seen by the unaided eye), and swollen lymph nodes. Skin rashes occur early in the disease, and peeling of the skin in the genital area, hands, and feet (especially around the nails and on the palms and soles) may occur in later phases. Some of these symptoms may come and go during the course of the illness. If left untreated, the symptoms will eventually relent, but coronary artery aneurysms will not improve, resulting in a significant risk of death or disability due to myocardial infarction (heart attack). If treated in a timely fashion, this risk can be mostly avoided and the course of illness cut short.[citation needed]

  • High-grade fever (greater than 39 °C or 102 °F; often as high
    as 40 °C or 104 °F) that normally lasts for more than 5 days
    if left untreated.
  • Red eyes (conjunctivitis) without pus or drainage, also known as
    "conjunctival injection"
  • Bright red, chapped, or cracked lips
  • Red mucous membranes in the mouth
  • Strawberry tongue, white coating on the tongue or prominent red bumps
    (papillae) on the back of the tongue
  • Red palms of the hands and the soles of the feet
  • Rash which may take many forms, but not vesicular (blister-like),
    on the trunk
  • Swollen lymph nodes (frequently only one lymph node is swollen), particularly
    in the neck area
  • Joint pain (arthralgia) and swelling, frequently symmetrical
  • Irritability
  • Tachycardia (rapid heart beat)
  • Peeling (desquamation) palms and soles (later in the illness); peeling
    may begin around the nails
  • Beau's lines (transverse grooves on nails)



During the second phase, which usually begins within 2 weeks of when
the fever started, the skin on the hands and feet may begin to peel in
large pieces. The child also may experience joint pain, diarrhea, vomiting,
or abdominal pain. If your child shows any of these symptoms, call your
doctor.




Diagnosis

No single test can detect Kawasaki disease, so doctors usually diagnose it by evaluating the symptoms and ruling out other conditions.

Most kids diagnosed with Kawasaki disease will have a fever lasting 5 or more days and at least four of these symptoms:
  • redness in both eyes
  • changes around the lips, tongue, or mouth
  • changes in the fingers and toes, such as swelling, discoloration, or peeling
  • a rash in the trunk or genital area
  • a large swollen lymph node in the neck
  • red, swollen palms of hands and soles of feet

If Kawasaki disease is suspected, the doctor may order tests to monitor heart function (such as an echocardiogram) and might take blood and urine samples to rule out other conditions, such as scarlet fever, measles, Rocky Mountain spotted fever, juvenile rheumatoid arthritis, or an allergic drug reaction.

Treatement


Treatment should begin as soon as possible, ideally within 10 days of when the fever begins. Usually, a child is treated with intravenous doses of gamma globulin (purified antibodies), an ingredient of blood that helps the body fight infection. The child also might be given a high dose of aspirin to reduce the risk of heart problems.

Site Refference


http://kidshealth.org/parent/medical/heart/kawasaki.html
http://en.wikipedia.org/wiki/Kawasaki_syndrome
http://women.sanook.com/health/healthcare/sick_43038.php

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