North Devon District Hospital, England
Posters & Accepted Abstracts: Pediatr Ther
Kawasaki disease is the most common vasculitic syndrome occurring in childhood.The main complication of Kawasaki disease is increased likely hood of developing Coronary Artery aneurysm(CA), the incidence of which can be decreased by administration of IVIG(Intravenous immunoglobulins) within 7-10 days following the onset of the disease. Es-tablishing an accurate diagnosis of atypical KD is quite difficult,resulting in delayed admin-istration of IVIG therefore increasing the risk of patients developing CA. A 5 month old pre-viously healthy child was admitted on 15th of august with a 5-day history of fever, cough and coryzal like symptoms. He later developed other features such as maculopapular rash and non suppurative conjunctivitis. Initial blood results,symptoms and radiological findings moved us to consider a possible viral ethology of EBV, HSV which showed to be negative on further investigation. 4 days post admission the fever seemed to have subsided following administra-tion of IV Ceftriaxone and Azithromycin and the child was discharged. On 27th of August patient was readmitted with periungual desquamation. Bloods test revealed platelets peaking at 875. A diagnosis of Kawasaki disease was strongly suspected. This was confirmed by an ECHO conducted on the 6th of Sep which showed dilation of right and left CA. This case highlights a need to maintain a high index of suspicion for atypical KD in case of infants be-low the age of 6 months who present with continuous fever, increased inflammatory markers and a high platelet count in later stages of their admission.
Vasundhara Priyadarshani has completed her MBBS, MUDR on from Charles University Prague First Faculty of Medicine in 2017. She is currently completing her foundation training in England at North Devon District Hospital. She has spent 4 months of her training in the paediatric department of NDDH.