Kawasaki Disease (Deep Dive R20)
EM Clerkship
Zack Olson, MD ; Mike Estephan, MD ; Maddie Watts, MD
4.9 • 816 Ratings
🗓️ 15 April 2021
⏱️ 11 minutes
🧾️ Download transcript
Summary
Kawasaki Disease
A small vessel vasculitis that affects children, usually <5 years old.
Symptoms – remember the CRASH AND BURN mnemonic!
Conjunctivitis
Rash – nonspecific morbilliform or maculopapular rash, usually on torso
Adenopathy – usually unilateral cervical lymphadenopathy
Strawberry Tongue – erythema, swelling, or cracking of lips/mucous membranes
Hands – swelling, erythema, or desquamation of the hands/feet
BURN – 5 days of fever
Diagnosis:
* COMPLETE KAWASAKI – 5 days of fever and 4/5 of the CRASH symptoms
* INCOMPLETE KAWASAKI – 5 days of fever and 2-3/5 of the CRASH symptoms, in the setting of elevated inflammatory markers (WBC, ESR, CRP)
Treatment: IVIG and High Dose Aspirin
Multisystem Inflammatory Syndrome in Children (MIS-C)
A new disease entity seen in children defined by widespread systemic inflammation affecting multiple organ systems that presents weeks after infection by COVID-19.
Symptoms:
* Persistent Fever* Skin involvement – nonspecific rash, conjunctivitis, changes to mucous membranes* GI involvement – nonspecific abdominal pain, nausea, vomiting, diarrhea* Renal involvement – acute kidney injury with elevated creatinine* Cardiac involvement – elevated troponin/pro-BNP, reduced EF, cardiogenic shock* Neuro involvement – altered mental status
Diagnosis and Treatment: Varies by hospital, but usually involves the presence of clinical symptoms along with a positive covid IgM/IgG, elevated inflammatory markers (WBC, ESR, CRP, Ferritin, DDimer), multisystem involvement (elevated troponin/proBNP, elevated creatinine, elevated LFTs, etc). These children need a stat ECHOcardiogram to rule out significant cardiac dysfunction.
Transcript
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| 0:00.0 | Hello, students. My name is Mike Estefan, and I want to thank you for joining me today on the EM Clerkship Podcast. |
| 0:10.2 | This marks our third mid-month episode in our Deep Dive series, which if you're not familiar, |
| 0:15.8 | is our series of mid-month episodes where we dissect the topic that was covered in the mock oral |
| 0:21.3 | board's case from earlier in the month. Today's episode is going to be covering |
| 0:26.3 | Kawasaki disease with some bonus information about multi-system inflammatory syndrome in children, |
| 0:32.8 | abbreviated Miss C. Before we begin, I want to give a quick shout out to our sponsor's Pearson Rabbits. |
| 0:39.9 | As you probably know from our previous episodes, Pearson Rabbits is a company that specializes |
| 0:45.1 | in assisting medical professionals like you and me to understand the jargon behind disability |
| 0:50.4 | insurance and find a disability insurance plan that is catered towards your specific |
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| 1:02.4 | during an emergent delivery at work. She has firsthand experienced the process of undergoing |
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| 1:13.3 | navigating the disability insurance landscape. Now, I know most of our listeners are medical |
| 1:18.9 | students and our residents, and most of you are young and healthy. This time in your life, |
| 1:24.6 | when you are so young and healthy, is the ideal time to sign up for |
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| 1:42.6 | ravitz.com and schedule a meeting with Stephanie Pearson and her team today. |
| 1:48.7 | Now, back to our episode. |
| 1:51.3 | Kawasaki disease. |
| 1:53.2 | This is a small vessel vasculitis that primarily affects children under the age of five, |
| 1:58.4 | and is also the leading cause of acquired heart disease amongst |
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