Fever in the pediatric patient. The importance of repeated physical examination
Journal: Advances in Medicine and Engineering Interdisciplinary Research DOI: 10.32629/ameir.v4i2.5257
Abstract
Clinical pictures consisting of fever and systemic inflammation with mucocutaneous involvement can be caused by multiple aetiologies. Prognosis, in some cases, depends on diagnosis and on early treatment. We present the clinical case of a boy seen in the emergency department with fever, and abdominal and cervical pain. In this case, findings of leucocytosis, neutrophilia, increased acute phase reactants and transaminases initially lead to gastrointestinal disease. However, continued physical examination and high degree of suspicion enabled to make the correct diagnosis of Kawasaki disease using echocardiogram within the first five days of the disease. The treatment was intravenous gamma globulin, with a favourable evolution and complete recovery four months after diagnosis.
Keywords
pediatrics; fever; Kawasaki disease; cardiology
Full Text
PDF - Viewed/Downloaded: 0 TimesReferences
[1] McCrindle BW, Rowley AH, Newburger JW, Burns JC, Bolger AF, Gewitz M et al. Diagnosis, treatment and long-term managemente of Kawasaki disease: a scientific statement for health professionals from the American Heart Association. Circulation. 2017; 135 (17): e927-e999.
[2] Ayusawa M, Sonobe T, Uemura S, Ogawa S, Nakamura Y, Kiyosawa N et al. Revision of diagnostic guidelines for Kawasaki disease (the 5th revised edition). Pediatr Int. 2005; 47 (2): 232-4.
[3] Dominguez SR, Anderson MS, El-Adawy M, Globé MP. Peventing coronary artery abnormalities: a need for earlier diagnosis and treatment of Kawasaki disease. Pediatr Infect Dis J. 2012; 31 (12): 1217-20.
[4] Nakamura Y, Yashiro M, Uehara R, Watanabe M, Tajimi M, Oki I et al. Use of laboratory data to identify risk factors of giant coronary aneurysms due to Kawasaki disease. Pediatr Int. 2004; 46 (1): 33-8.
[5] Sundel RP. Update on the treatment of Kawasaki disease in chilhood. Curr Rheumatol Rep. 2002; 4 (6): 474-82.
[6] Cimaz R, Sundel R. Atypical and incomplete Kawasaki disease. Best Pract Res Clin Rheumatol. 2009; 23 (5): 689-97.
[7] Yanagawa H, Tuohong Z, Oki I, Nakamura Y, Yashiro M, Ojima T et al. Effect of gamma-globulin on the cardiac sequelae of Kawasaki disease. Pediatr Cardiol. 1999; 20 (4):248-51.
[8] Muniz JC, Dummer K, Gauvreau K, Colan SD, Fulton DR, Newburger JW. Coronary artery dimensions in febrile children without Kawasaki disease. Circ Cardiovasc Imaging. 2013; 6 (2): 239-44.
[2] Ayusawa M, Sonobe T, Uemura S, Ogawa S, Nakamura Y, Kiyosawa N et al. Revision of diagnostic guidelines for Kawasaki disease (the 5th revised edition). Pediatr Int. 2005; 47 (2): 232-4.
[3] Dominguez SR, Anderson MS, El-Adawy M, Globé MP. Peventing coronary artery abnormalities: a need for earlier diagnosis and treatment of Kawasaki disease. Pediatr Infect Dis J. 2012; 31 (12): 1217-20.
[4] Nakamura Y, Yashiro M, Uehara R, Watanabe M, Tajimi M, Oki I et al. Use of laboratory data to identify risk factors of giant coronary aneurysms due to Kawasaki disease. Pediatr Int. 2004; 46 (1): 33-8.
[5] Sundel RP. Update on the treatment of Kawasaki disease in chilhood. Curr Rheumatol Rep. 2002; 4 (6): 474-82.
[6] Cimaz R, Sundel R. Atypical and incomplete Kawasaki disease. Best Pract Res Clin Rheumatol. 2009; 23 (5): 689-97.
[7] Yanagawa H, Tuohong Z, Oki I, Nakamura Y, Yashiro M, Ojima T et al. Effect of gamma-globulin on the cardiac sequelae of Kawasaki disease. Pediatr Cardiol. 1999; 20 (4):248-51.
[8] Muniz JC, Dummer K, Gauvreau K, Colan SD, Fulton DR, Newburger JW. Coronary artery dimensions in febrile children without Kawasaki disease. Circ Cardiovasc Imaging. 2013; 6 (2): 239-44.
Copyright © 2026 Isabel Miras Aguilar, Pilar Sevilla Ramos, Gema Arriola Pereda, Alfonso Ortigado Matamala
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License