Kawasakis Syndrome

Kawasaki's syndrome (KS), also known as Kawasaki's disease, is the leading cause of acquired heart disease in children. Prolonged high fever (up to 40° C [104° F]), with an urticaria-like rash and injection of mucous membranes, including a strawberry tongue, is followed by erythema of

The complete reference list is available online at www.expertconsult.com.

General Reference

www.rheumatology. org

American College of Rheumatology; Internet resources, academic and government sites, foundations/ associations. www.arthritis.org

Arthritis Foundation; excellent site, primarily for patients.

the palms and soles and desquamation of the fingertips. Most patients have cervical lymphadenopathy. A myocarditis is present in more than 50% of patients and is manifested by a tachycardia. Many other symptoms might also occur, such as respiratory, neurologic, and GI symptoms (Box 32-5). Because KS symptoms resolve spontaneously, cardiac manifestations might not be diagnosed. A coronary arteritis and even aneurysms might develop, with significant morbidity and mortality. Laboratory studies are not helpful. Serial electrocardiograms are recommended at diagnosis, 2 to 3 weeks into the illness, and 1 month after that.

Although KS's seasonal variation (winter and spring) and epidemics suggest an infectious cause, none has yet been identified. IV fluids, aspirin, and IVIG have been used most frequently for KS. Antibiotics are of no use unless there is a concomitant bacterial infection. Steroids might actually increase the incidence of aneurysms and should be avoided, if possible.

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