A boy with Kawasaki Disea...

A boy, aged 3 years with a body weight of 13 kg and height of 90 cm, was brought by his parents to your practice with complaints of high fever (temperature can reach 40o C) since 9 days SMRS. In addition to high fever, the parents reported that the patient's eyes were red but there was no thick mucus. Since the illness, the patient's lips have also become dry and cracked. Previously, the patient had been taken to a general practitioner and was said to have measles due to fever and redness on her body. On physical examination, a strawberry tongue was found (picture attached), erythema on the pharynx and oral cavity. Erythema was also found on the palms and feet. Laboratory examination revealed the following results: ESR 65 mm/hour, albumin 2 gr/dl, platelets 500,000/mm3, in complete urine found leukocytes.

The patient was diagnosed with acute phase complete kawasaki disease. and was managed with hospitalization and consulted to pediatric cardiology. Echocardiographic examination was performed and an aneurysm was found. Intravenous Immunoglobulin (gammaglobulin) (IVIG) was given immediately after the diagnosis was made with confidence at a dose of 2 gr/kgBB for 10-12 hours (started within 10 days after onset), methylprednisolone 30 mg/kg IV over 2 - 3 hours in a single dose for 1 - 3 days, salicylic acid orally 80-100 mg/kgBB/day divided into 4 doses until the 14th day of onset or after 2-3 days of fever subsiding, the dose is reduced to 3-5 mg/kgBB once daily until 6-8 weeks from onset and then discontinued if no coronary abnormalities are found on echocardiography. Long-term administration is given in persistent coronary artery aneurysms. Immunization with live germs such as measles or varicella is delayed for at least 11 months after immunoglobulin administration. Other immunizations can be given after the convalescent phase.