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It is very common for children to have a cold and a fever. There is a disease whose symptoms are very similar to a cold, but it is much more serious than a cold. If treatment is delayed, it may cause harm heart.
The Pediatrics Department of Zhejiang Provincial People’s Hospital has recently treated 3 such children, all of whom are under 5 years old.
4-year-old boy with continuous feverKawasaki disease confirmed
“We admitted The three cases can be called incomplete Kawasaki disease, and they were all diagnosed and treated in time,” said Zhu Haiqiao, chief physician of the Department of Pediatrics at the Provincial People’s Hospital.
Guoguo is 4 years old this year, from a town in northern Zhejiang. After 2 days of fever, routine blood tests found that white blood cells and C-reactive protein were extremely elevated, and the initial diagnosis of “sepsis” was admitted to hospital.
After being hospitalized, Director Zhu Haiqiao and Deputy Chief Physician Chen Guoqing and others carefully observed that a disease gradually revealed its “true face”: in addition to persistent fever, Guoguo also appeared in sequence with bayberry The tongue and finger end were hard and swollen, the skin at the BCG vaccination site was red, and erythema appeared on the palms and soles of the feet; after antibiotic treatment, the inflammatory indexes in the blood did not decrease significantly, the platelets increased progressively, and the cervical lymph nodes also increased. Da… Guoguo was diagnosed with Kawasaki disease.
Next, as usual, doctors used high-dose intravenous gamma globulin and oral aspirin. After 24 hours, the child’s body temperature dropped, and the inflammatory indicators were re-examined and gradually returned to normal. Subsequently, the body temperature was normal, and he was discharged from the hospital two days later.
“A prerequisite for the diagnosis of the disease is a fever of more than 5 days, and several other evidences, including rash, bayberry tongue, swollen lymph nodes, fingers and toes. End peeling, conjunctival congestion. If coronary artery dilatation occurs, the number of diagnostic items can also be relaxed, and the diagnosis can be made without having the above items.” Director Zhu Haiqiao said that for those with insufficient diagnostic conditions, it is academically called incomplete. type Kawasaki disease. The fever of the 3 children with Kawasaki disease was less than 5 days, which is easy to be ignored in clinical practice, and it is easy to delay the diagnosis. To this end, experts believe that in children with unexplained fever for more than 72 hours, the possibility of Kawasaki disease should be considered.
If not diagnosed and treated in time, it will endanger the heart
Director Zhu Haiqiao introduced that Kawasaki disease is an autoimmune vasculitis associated with infection. In 1967, Dr. Tomisaku Kawasaki, Japan reported for the first time. 80% of patients develop disease within 5 years of age. The typical symptoms are fever, rash, red eyes, bayberry tongue, hard swelling or peeling of fingers and toes, swollen lymph nodes, etc. If not diagnosed and treated early, about half of the cases will be There will be serious consequences such as coronary artery damage and coronary artery dilation to form aneurysms.
“The main hazard of Kawasaki disease is coronary artery disease, which is the main cause of acquired heart disease in children. Therefore, early diagnosis of the disease is very important. Timely diagnosis and treatment with C-globulin within days can prevent complications of coronary artery damage.”
Attention screening for Kawasaki disease and common cold >
Once a child has a fever, many people will first think of acute upper respiratory tract infection. So, what is the common cold or Kawasaki disease, how should parents identify and deal with it? Zhu Haiqiao introduced the following points:
First, the common cold is usually accompanied by respiratory symptoms, such as cough, runny nose, nasal congestion, sore throat, etc., while Kawasaki The disease does not necessarily have these symptoms. Its characteristics include fever, rash, eye congestion, bayberry tongue, swollen and peeling fingers, etc.. Once suspected symptoms are found, timely medical treatment, examination and diagnosis should be made to avoid missing the best time for treatment.
Secondly, in addition to acute treatment, the follow-up of Kawasaki disease is also important. Because coronary lesions sometimes occur several weeks after the onset, once coronary changes occur, the recovery process will last one to two years. Therefore, it is recommended that the children should be followed up in the outpatient clinic for two years, and the echocardiography should be reviewed regularly to detect changes in the coronary arteries.
(Chen Xiaoqing and Song Lisheng)
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