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Kawasaki Disease
Kawasaki disease or mucocutaneous lymph node syndrome is a relatively rare acute febrile illness in children. The cause of Kawasaki disease is unknown but it can mimic other viral and bacterial illnesses. This fact makes the disease diagnosable only after other more common causes for a febrile illness are excluded with appropriate testing. Kawasaki disease usually affects children under the age of 12. It is characterized by unresponsiveness to antibiotics, cervical lymphadenitis, and changes in the skin and mucus membranes, mouth, and lips. A rash can be seen to the trunk in addition to swelling to the tops of the hands and feet, fissured lips, strawberry tongue, redness of the eyes, lips, and pharynx. Eventually the skin can peel, particularly on the fingertips. Laboratory findings include an elevated white blood cell count (mostly lymphocytes), increased erythrocyte sedimentation rate (ESR), and thrombocytosis.
In order to confirm the diagnosis of Kawasaki disease there should be at least five days of fever, unexplained by any other known disease. Other infectious diseases that can be confused with Kawasaki disease include: Streptococcal pharyngitis, viral pharyngitis, scarlet fever, Rocky mountain spotted fever, mononucleosis, and toxic shock syndrome. A drug reaction can also present with similar findings. Although Kawasaki disease is generally benign and self-limited, it is associated with coronary artery aneurysms in 17 to 31 percent of cases. These complications generally occur in the third to fourth week of illness. Apart from the up to 2.8% of patients who develop fatal complications, the prognosis of this disease for uneventful recovery is excellent. Treatment includes high dose gama globulin for four consecutive days together with aspirin for several weeks. The Pediatrician will be the expert in the diagnosis and management of this condition.
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