Travis in Hospital
Submitted by
Valorie on Mon, 03/24/2008 at 1:42pm.
Travis has been sick for about 5 days with a very high fever. Robie took him in last week and they suspected Roseola. He also had swollen glands which is common for a high fever--meaning infection somewhere. The advise nurse agreed that was probably the case when Robie called again a few days later. However, I guess yesterday Robie researched the symptons and felt they seemed to be the same symptons as Kawasaki Disease. She called the advise nurse and told her and the advise nurse said "oh no, that is too rare". I guess Robie took him in and he was diagnosed as having Kawasaki Disease. He is now in University of OHSU--I believe that is what it is called--the one with the tram by Geoff's old work. They did catch it quick so probably no heart damage and none of the worse effects as you can read here. It is VERY rare and is usually found in Asian boys--named after the doctor who discovered it. GOOD JOB, ROBIE. I am sure Sean and Robie can add more to this blog but I wanted to get the word out to our family ASAP.
Kawasaki disease, also known as lymph node syndrome, mucocutaneous node disease, infantile polyarteritis and Kawasaki syndrome, is a poorly understood self-limited vasculitis that affects many organs, including the skin and mucous membranes, lymph nodes, blood vessel walls, and the heart. It does not seem to be contagious. It was first described in 1967 by Dr. Tomisaku Kawasaki in Japan.[1]
By far, the highest incidence of Kawasaki disease occurs in Japan (175 per 100,000), though its incidence in the United States is increasing. Kawasaki disease is predominantly a disease of young children, with 80% of patients younger than 5 years of age. Additional risk factors in the United States include Asian race and male sex. The causative agent of Kawasaki disease is still unknown. However, current etiological theories center primarily on immunological causes for the disease. Much research is being performed to discover a definitive toxin or antigenic substance, possibly a superantigen, that is the specific cause of the disease. An unknown virus may play a role as an inciting factor as well. The cardiac complications are, by far, the most important aspect of the disease. Kawasaki disease can cause vasculitic changes (inflammation of blood vessels) in the coronary arteries and subsequent coronary artery aneurysms. These aneurysms can lead to myocardial infarction (heart attack) even in young children. Overall, about 10–18% of children with Kawasaki disease develop coronary artery aneurysms Kawasaki syndrome and risk factors for coronary artery abnormalities: United States, 1994-2003. with much higher prevalence among patients who are not treated early in the course of illness. Kawasaki disease and rheumatic fever are most common causes of acquired heart disease among children in the United States.
Kawasaki disease often begins with a high and persistent fever that is not very responsive to normal doses of paracetamol (acetaminophen) or ibuprofen. The fever may persist steadily for up to two weeks and is normally accompanied by irritability. Affected children develop red eyes, red mucous membranes in the mouth, red cracked lips, a "strawberry tongue", iritis, keratic precipitates (detectable by an ophthalmologist but usually too small to be seen by the unaided eye), and swollen lymph nodes. Skin rashes occur early in the disease, and peeling of the skin in the genital area, hands, and feet (especially around the nails and on the palms and soles) may occur in later phases. Some of these symptoms may come and go during the course of the illness. If left untreated, the symptoms will eventually relent, but coronary artery aneurysms will not improve, resulting in a significant risk of death or disability due to myocardial infarction (heart attack). If treated in a timely fashion, this risk can be mostly avoided and the course of illness cut short.
High-grade fever (greater than 39 °C or 102 °F; often as high as 40 °C or 104 °F) that normally lasts for more than a week if left untreated.
Red eyes (conjunctivitis) without pus or drainage, also known as "conjunctival injection"
Bright red, chapped, or cracked lips
Red mucous membranes in the mouth
Strawberry tongue, white coating on the tongue or prominent red bumps (papillae) on the back of the tongue
Red palms of the hands and the soles of the feet
Swollen hands and feet
Rash which may take many forms, but not vesicular (blister-like), on the trunk
Swollen lymph nodes (frequently only one lymph node is swollen), particularly in the neck area
Joint pain (arthralgia) and swelling, frequently symmetrical
Irritability
Tachycardia (rapid heart beat)
Peeling (desquamation) palms and soles (later in the illness); peeling may begin around the nails
Children with Kawasaki disease should be hospitalized and cared for by a physician who has experience with this disease. When in an academic medical center, care is often shared between pediatric cardiology and pediatric infectious disease specialists, although no infectious agent has been demonstrated. It is imperative that treatment be started as soon as the diagnosis is made to prevent damage to the coronary arteries.
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