Home / Images / Visual Diagnosis # 6

Visual Diagnosis # 6

 

 

A mother brings her 5 year old son in for evaluation of fever and rash which have persisted over the past 6 days despite acetaminophen and ibuprofen. He has had a mild cough without shortness of breath. He complains only of a sore throat and left ear pain. He had one day of vomiting and diarrhea which had self resolved 48 hours ago. Since that time he has had very little oral intake. Has has no significant PMHx. FTVD. All immunizations are up to date. No other recent illnesses, known sick contacts or recent travel.

Vitals signs:

Temp: 102.8 °F (39.3°C), HR: 122, RR: 24, BP: 92/58, Sat.99%

He is alert and acting normally per mother.

As you perform a more thorough ENT exam, the child appears to have a moderate conjunctival and scleral injection without discharge and a left otitis media. He also appears to have significant left sided cervical and tonsillar LAD and bilateral tonsillar erythema without exudate.

PreviewScreenSnapz006-300x285

 

 

 

 

 

 

 

 

 

 

His lips and oral mucous membranes are quite dry with diffuse erythema.

Kawasaki-Disease

 

 

 

 

 

 

 

His lungs are CTA B/L, normal heart exam without murmur. Abdominal exam is benign. You also notice a peeling, slightly erythematous rash to the hands and feet.

Kawasaki Disease - featured image - 60secondem

 

 

 

 

 

 

 

 

1. What should be high on your differential list?

2. What complications might you be concerned about?

3. What is the treatment?

4. What is the prognosis?

 

 

ANSWERS button

 

 

 

 

 

 

 

 

Share this:

Leave a Reply

Your email address will not be published.

* Copy This Password *

* Type Or Paste Password Here *

This site uses Akismet to reduce spam. Learn how your comment data is processed.