Safety netting versus overtreatment in paediatrics: viral infection or incomplete Kawasaki disease?

BMJ Case Rep. 2017 Nov 8:2017:bcr2017222323. doi: 10.1136/bcr-2017-222323.

Abstract

Kawasaki disease (KD) is the most common systemic vasculitis of childhood. The following presentation of a 4-year-old Irish boy referred to a secondary care paediatric service from the community with prolonged fever, oral mucous membrane changes and painless blistering lesions of the hands and feet in the presence of elevated inflammatory markers serves as an opportunity to discuss the diagnostic criteria and treatment for KD and incomplete KD, an often missed diagnosis with significant paediatric morbidity outside an academic paediatric centre.

Keywords: cardiovascular medicine; emergency medicine; medical education; paediatrics; primary care.

Publication types

  • Case Reports

MeSH terms

  • Algorithms
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use
  • Child, Preschool
  • Diagnosis, Differential
  • Exanthema / complications
  • Exanthema / diagnosis*
  • Exanthema / etiology
  • Fever / complications
  • Fever / diagnosis*
  • Fever / etiology
  • Humans
  • Immunoglobulins, Intravenous / administration & dosage
  • Immunoglobulins, Intravenous / therapeutic use
  • Male
  • Medical Overuse / prevention & control*
  • Mucocutaneous Lymph Node Syndrome / complications
  • Mucocutaneous Lymph Node Syndrome / diagnosis
  • Mucocutaneous Lymph Node Syndrome / therapy
  • Mucocutaneous Lymph Node Syndrome / virology*
  • Treatment Outcome
  • Virus Diseases / complications
  • Virus Diseases / diagnosis

Substances

  • Anti-Bacterial Agents
  • Immunoglobulins, Intravenous