MedicalCareer版 - Kawaski disease? Pediatricans please come in to discuss this case. |
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发帖数: 374 | 1 A four-year-old asian boy has fever ranging from 102 F to 104 F for more
than five days. Fever can be reduced by taking acetaminophen and ibuprophen
. Bilateral eyes are slightly pinkish. Lips are erythematous but no
fissure. Tongue and oropharynx are normal. No lymphadenopathy, extremity
swelling, and rash. Pediatric Transthoracic endocardiogram report shows no
abnormal findings except patent foramen ovale and physiological tricuspid
and pulmonary valve regurgitation. Blood culture negative. Complete blood
count is normal except Neutrophils 58% (normal 23-33%), lymphocytes 30% (
normal value is 47-76%), monocytes 11% (normal 2-8%). Comprehensive
metabolic panel shows creatinine 0.4 (normal 0.8-1.3). Other labs are
normal. ESR is 23 (normal value 0-10).
(1) This boy meets some criteria of Kawaski disease. But his neutrophil
percentage is high. Should we treat it as kawaski disease?
(2) If kawaski disease is suscepted. IV immunoglobulin and high dose
aspirin should be given or not?
(3) Should we continue maintenance dose for next 6-8 weeks? |
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