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Kawasaki disease − often a diagnostic dilemma in pediatric population: a case report

Kawasaki disease (KD) is the most common cause of childhood vasculitis affecting small- and medium-sized arteries. The cause of this disease is unknown with an overall prevalence of 0.10% making this a rare entity. CASE PRESENTATION: Here the authors present an index case of a 2-year-old child prese...

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Autores principales: Subedi, Subash, Shrestha, Swikriti, Khatri Chhetri, Sujata, Lamichhane, Sandesh, Dhakal, Swastika, Dahal, Pravakar, Baniya, Shubha, Pokhrel, Santosh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10205189/
https://www.ncbi.nlm.nih.gov/pubmed/37229038
http://dx.doi.org/10.1097/MS9.0000000000000472
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author Subedi, Subash
Shrestha, Swikriti
Khatri Chhetri, Sujata
Lamichhane, Sandesh
Dhakal, Swastika
Dahal, Pravakar
Baniya, Shubha
Pokhrel, Santosh
author_facet Subedi, Subash
Shrestha, Swikriti
Khatri Chhetri, Sujata
Lamichhane, Sandesh
Dhakal, Swastika
Dahal, Pravakar
Baniya, Shubha
Pokhrel, Santosh
author_sort Subedi, Subash
collection PubMed
description Kawasaki disease (KD) is the most common cause of childhood vasculitis affecting small- and medium-sized arteries. The cause of this disease is unknown with an overall prevalence of 0.10% making this a rare entity. CASE PRESENTATION: Here the authors present an index case of a 2-year-old child presenting with a persistent high-grade fever of more than 5 days and a 3-day history of bilateral swelling of hands and feet along with cervical lymphadenopathy. On the subsequent day of admission, the child developed mucocutaneous symptoms and cervical lymphadenopathy. The diagnosis of KD was made, and it was successfully treated with intravenous immunoglobulin and aspirin. CLINICAL DISCUSSION: Timely diagnosis and early treatment of KD are challenging due to the lack of definitive diagnostic tests. Watchful waiting for symptoms may be necessary before a diagnosis can be made because not all clinical symptoms are present simultaneously as in the index case. CONCLUSIONS: This case highlights considering KD as a differential diagnosis of nonresolving fever in children with mucocutaneous findings. Intravenous immunoglobulin along with aspirin is the mainstay of therapy and should be started as early as possible to prevent detrimental cardiac complications. There is a high tendency of diagnostic dilemmas due to a wide array of nonspecific presentations thus healthcare providers must be more vigilant of this entity.
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spelling pubmed-102051892023-05-24 Kawasaki disease − often a diagnostic dilemma in pediatric population: a case report Subedi, Subash Shrestha, Swikriti Khatri Chhetri, Sujata Lamichhane, Sandesh Dhakal, Swastika Dahal, Pravakar Baniya, Shubha Pokhrel, Santosh Ann Med Surg (Lond) Case Reports Kawasaki disease (KD) is the most common cause of childhood vasculitis affecting small- and medium-sized arteries. The cause of this disease is unknown with an overall prevalence of 0.10% making this a rare entity. CASE PRESENTATION: Here the authors present an index case of a 2-year-old child presenting with a persistent high-grade fever of more than 5 days and a 3-day history of bilateral swelling of hands and feet along with cervical lymphadenopathy. On the subsequent day of admission, the child developed mucocutaneous symptoms and cervical lymphadenopathy. The diagnosis of KD was made, and it was successfully treated with intravenous immunoglobulin and aspirin. CLINICAL DISCUSSION: Timely diagnosis and early treatment of KD are challenging due to the lack of definitive diagnostic tests. Watchful waiting for symptoms may be necessary before a diagnosis can be made because not all clinical symptoms are present simultaneously as in the index case. CONCLUSIONS: This case highlights considering KD as a differential diagnosis of nonresolving fever in children with mucocutaneous findings. Intravenous immunoglobulin along with aspirin is the mainstay of therapy and should be started as early as possible to prevent detrimental cardiac complications. There is a high tendency of diagnostic dilemmas due to a wide array of nonspecific presentations thus healthcare providers must be more vigilant of this entity. Lippincott Williams & Wilkins 2023-04-07 /pmc/articles/PMC10205189/ /pubmed/37229038 http://dx.doi.org/10.1097/MS9.0000000000000472 Text en Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (https://creativecommons.org/licenses/by/4.0/) (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/)
spellingShingle Case Reports
Subedi, Subash
Shrestha, Swikriti
Khatri Chhetri, Sujata
Lamichhane, Sandesh
Dhakal, Swastika
Dahal, Pravakar
Baniya, Shubha
Pokhrel, Santosh
Kawasaki disease − often a diagnostic dilemma in pediatric population: a case report
title Kawasaki disease − often a diagnostic dilemma in pediatric population: a case report
title_full Kawasaki disease − often a diagnostic dilemma in pediatric population: a case report
title_fullStr Kawasaki disease − often a diagnostic dilemma in pediatric population: a case report
title_full_unstemmed Kawasaki disease − often a diagnostic dilemma in pediatric population: a case report
title_short Kawasaki disease − often a diagnostic dilemma in pediatric population: a case report
title_sort kawasaki disease − often a diagnostic dilemma in pediatric population: a case report
topic Case Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10205189/
https://www.ncbi.nlm.nih.gov/pubmed/37229038
http://dx.doi.org/10.1097/MS9.0000000000000472
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