Pictorial - Case Study

THE CASE

A three-year-old boy presented with a seven-day history of fever. He had a polymorphous rash and bilateral conjunctival infection. On examination he had cervical lymphadenopathy (about 1.5 cm in diameter), red and cracked lips as well as a red throat. He was apyrexial and the skin of his palms and soles was starting to peel. What is the diagnosis, management and differential diagnoses?

DIAGNOSIS AND MANAGEMENT

The diagnosis is Kawasaki disease. It may take six to eight weeks for the symptoms to resolve. The joints may also be inflamed, especially larger weight-bearing joints. Treatment is most effective if given in the first 10 days of the disease to prevent some coronary damage. Aspirin is used to decrease inflammation and lower fever, as well as to prevent blood clots. Although some children recover without treatment, 15-25 per cent have coronary artery damage. The boy was referred to the paediatrician.

POSSIBLE DIFFERENTIAL DIAGNOSES
- Scarlet fever.
- Erythema multiforme.
- Stevens-Johnson syndrome.
- Erythema infectiosum.

DIFFERENTIAL DIAGNOSIS
Scarlet fever
- Tonsillitis or pharyngitis.
- Diffuse erythematous rash on trunk.
- Sore tongue.
- Circumoral pallor.

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in

Before commenting please read our rules for commenting on articles.

If you see a comment you find offensive, you can flag it as inappropriate. In the top right-hand corner of an individual comment, you will see 'flag as inappropriate'. Clicking this prompts us to review the comment. For further information see our rules for commenting on articles.

comments powered by Disqus