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A CASE OF KAWASAKI DISEASE IN AN EIGHT-YEAR-OLD BOY
Ganna K Kopiyka1, Tetiana Y Kravchenko1, Olena M Artomova2
1ODESA NATIONAL MEDICAL UNIVERSITY, ODESA, UKRAINE.
Insights
Kawasaki disease is a rare but serious condition affecting children's arteries. Early diagnosis and echocardiography are crucial to prevent severe cardiovascular complications.
Area of Science:
- Pediatric Rheumatology
- Cardiovascular Pathology
- Infectious Diseases
Background:
- Kawasaki disease is an acute febrile illness impacting medium and small arteries, leading to vasculitis.
- Its etiology remains debated, with infectious, autoimmune, and genetic factors implicated.
- Diagnosis relies on clinical criteria, supported by laboratory and ancillary findings.
Observation:
- This article details a case of Kawasaki disease in an 8-year-old boy with prolonged fever and four of five diagnostic criteria.
- Delayed diagnosis occurred on day 10 due to varied and inconsistent symptoms.
- The condition mimicked other illnesses like viral infections and connective tissue diseases.
Findings:
- Late diagnosis in this case highlights the challenge of recognizing Kawasaki disease.
- The importance of considering Kawasaki disease in children with prolonged fever is emphasized.
- Cardiovascular complications pose a significant risk if diagnosis and treatment are delayed.
Implications:
- Prompt diagnosis of Kawasaki disease is vital to mitigate severe cardiovascular sequelae.
- Mandatory echocardiography within 10 days is recommended for children with unexplained fever and elevated acute-phase reactants.
- Differential diagnosis should include Kawasaki disease for persistent fevers, especially when mimicking other conditions like MIS-C.
Abstract:
Kawasaki disease is an acute systemic disease characterized by the predominant lesions of middle and small arteries, alongside destructive and proliferative vasculitis development. The aetiology is currently being discussed. Infectious factors are mostly preferred, in addition, autoimmune mechanisms and genetic heredity are considered. The diagnosis of Kawasaki disease is established by clinical signs; laboratory changes are usually taken into account as are ancillary criteria. The article discusses the clinical case of Kawasaki disease in an 8-year-old boy. Given the variety and inconsistency of the clinical symptoms (the child had four of the five mandatory criteria together with prolonged fever), there was a late diagnosis, namely on day 10 of the disease. Due to the high risk of cardiovascular complications in the differential diagnosis of children with fever lasting more than 3 days should be considered Kawasaki disease, followed by mandatory heart echocardiography during the first 10 days of the disease, especially if the fever is accompanied by the increase of acute phase reactants. When treating children with chronic fever without a specific source, the doctor should be wary of Kawasaki disease, as it can clinically simulate acute respiratory viral disease, the onset of diffuse connective tissue disease, and infectious endocarditis, and can have common features and require differential diagnostics with coronavirus associated multisystem inflammatory syndrome.
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