Kawasaki disease

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Scab

I got nothin' here...
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Our 18 month old grandson started getting a little sick about Monday. His mom carried him to the doc with symptoms of fever, irritable, aches, and some rash around area 51. They really didn't know what it was but said that if his tongue broke out, bring him back immediately. So, fever spike up to 104, rash spread, huge welps, whites of eyes turned red, extremeties swelled, tongue broke out, and he was screaming nearly non-stop from the agony. They rushed him back to the doc. The doc immediately sent for the ambulance and had him transfered to Birmingham at the Childrens Hospital. (part of UAB) We have spent the majority of the day there.

As it turns out, he has KAWASAKI disease. No joke. I've personally never heard of such until today. But it is real. Rare, but real. Caused by a virus of unknown origin. Most often strikes children of Asian decent, but can affect any race. Strikes children before the age of 5. Strikes twice as many boys as girls. Is not inherited. Is not contagious. It causes the body to basically "turn on itself." Can result in heart damage, joint damage, lung damage, and occasionally heart attack and death.

WTF? Has anyone here even heard of this phantom that has crept into our lives? Does anyone have any long-term information as to what he will face in his future?

 
Kawasaki disease in Google produces over 1.8 million hits. The wiki hit is close to the top, like usual.

PrognosisWith early treatment, rapid recovery from the acute symptoms can be expected and the risk of coronary artery aneurysms greatly reduced. Untreated, the acute symptoms of Kawasaki disease are self-limited (i.e. the patient will recover eventually), but the risk of coronary artery involvement is much greater. Overall, about 2% of patients die from complications of coronary vasculitis. Patients who have had Kawasaki disease should have an echocardiogram initially every few weeks, and then every 1–2 years to screen for progression of cardiac involvement.

It is also not uncommon that a relapse of symptoms may occur soon after initial treatment with IVIG. This usually requires re-hospitalization and retreatment. Treatment with IVIG can cause allergic and non-allergic acute reactions, aseptic meningitis, fluid overload and, rarely, other serious reactions. Aspirin may increase the risk of bleeding from other causes and may be associated with Reye's syndrome. Overall, life-threatening complications resulting from therapy for Kawasaki disease are exceedingly rare, especially compared with the risk of non-treatment.

 
Wow scab. Something like that would give any parent/grandparent a heart attack. Glad they found out what it was, and caught it in time. Hope all works out to be good.

 
Kawasaki disease in Google produces over 1.8 million hits. The wiki hit is close to the top, like usual.
Yes, but "Kawasaki Disease" or "Kawasaki Syndrome" in quotes produces very accurate results in Google.

The top 15 results or so are all about this disease: Google Results

From Kids Health:

Kawasaki Disease is an illness that involves the skin, mouth, and lymph nodes, and typically affects children who are under the age of 5. The cause of Kawasaki Disease is unknown, but if the symptoms are recognized early, kids with the disease can fully recover within a few days. If it goes untreated, it can lead to serious complications that can involve the heart.

Kawasaki disease occurs in 19 out of every 100,000 kids in the United States. It is most common among children of Japanese and Korean descent, but the illness can affect all ethnic groups.

This illness can't be prevented, but you can help your child by learning the telltale symptoms and signs, which typically include a fever that lasts for at least 5 days, red eyes, a body rash and severely-chapped lips and mouth. If your child shows these symptoms it's a good idea to call the doctor.

Signs and Symptoms of Kawasaki Disease

The symptoms of Kawasaki Disease typically appear in phases.

The first phase, which can last for up to 2 weeks, usually involves a persistent fever that is higher than 104 degrees Fahrenheit (39 degrees Celsius), and lasts for at least 5 days. The other symptoms that typically develop include:

* severe redness in the eyes

* a rash on the child's stomach, chest, and genitals

* red, dry, cracked lips

* swollen tongue with a white coating and big red bumps

* sore, irritated throat

* swollen palms of the hands and soles of the feet with a purple-red color

* swollen lymph nodes

During the second phase of the illness, which usually begins within two weeks of when the fever first begins, the skin on the child's hands and feet may begin to peel in large pieces. The child may also experience joint pain, diarrhea, vomiting, or abdominal pain.

Complications of Kawasaki Disease

Doctors can manage the symptoms of Kawasaki disease if they catch it early. The symptoms typically disappear within just two days of when treatment begins. Usually, if Kawasaki disease is treated within 10 days of when the first symptoms begin, no heart problems develop.

But if the illness goes untreated (time period can vary, but likely for 10-14 days and sooner in young infants), it can lead to more serious complications that involve the child's heart. Kawasaki disease can lead to vasculitis, which is an inflammation of the blood vessels. This can be particularly dangerous because it can affect the coronary arteries, which supply blood to the heart.

In addition to the coronary arteries, the heart muscle, lining, valves, or the outer membrane that surrounds the heart can become inflamed. Arrhythmias (changes in the normal pattern of the heartbeat) or abnormal functioning of some heart valves can also occur.

Diagnosing Kawasaki Disease

There is no one test to detect Kawasaki disease, so a doctor typically diagnoses it by evaluating the child's symptoms and ruling out other conditions.

Typically, a child who is diagnosed with this illness will have a fever lasting 5 or more days and at least 4 of the following 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, a doctor may order tests to monitor the child's heart function, which can include an echocardiogram, and other tests of heart function. A doctor may also take blood and urine samples to rule out other conditions, such as scarlet fever, measles, Rocky Mountain Spotted Fever, Stevens-Johnson syndrome, juvenile rheumatoid arthritis, and an allergic drug reaction.

Treating Kawasaki Disease

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

Updated and reviewed by: Joel Klein, MD

Date reviewed: July 2005

Originally reviewed by: Steven Dowshen, MD

 
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Scab, in reading the above, it sounds like your doc done good in diagnosing it. The prognosis looks promising since it was caught early.

 
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Wow, how unusual. Sorry to hear about the little one. Seems like (from what I read on the 'net) that it's going to be treated and all taken care of. My thoughts are with you and your grandson. Keep us posted.

Tough year, eh Scab?

 
Scary stuff, I hate when kids are running high fevers!

Glad they figured out what it is and got him on the mend.

JW

 
Dang. Give the little one my best wishes! It sounds like he's in good hands now.

So do you think he'll be a Yamaha owner when he grows up? :)

 
Sorry to hear about your little guy but it sounds as though you have a smart doc who was on the ball with the diagnosis. I've seen a couple of cases of Kawasaki's disease. Most notable is the strawberry tongue.

Hope he's back to himself real soon. One of the nice things about sick kids is how fast they get to be well again, unlike us 'older' folks.

Jill

 
Scab,

GF is labor&delivery nurse. She has heard of the disease. Will check on it tomorrow for any further info/wisdom. Our prayers are with you all.

Jeff

 
Thanks for all the well wishes and information. This is some weird stuff, that's for sure. Today he was much better. He had a little temperature rise so they aren't considering sending him home till maybe tomorrow. Boy, he sure does look alot better now. Strange stuff indeed.

I tried to blame it on the wife, as she is the only one around that owns a kawasaki. She was not amused.

 

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