What is the routine diagnostic sequence for Kawasaki disease?

Many Kawasaki disease patients have suffered great physical and mental impacts due to the failure to receive timely treatment and are unable to live like normal people. According to experts, this disease is more common in children. Below we will introduce to you the routine diagnostic sequence of Kawasaki disease, hoping that it will be helpful to everyone.

symptom

50% to 70% of Kawasaki disease patients have unilateral or bilateral non-suppurative lymphadenopathy in the early stage, which subsides after a few days. Sometimes the swelling spreads to the submandibular area, and is even misdiagnosed as mumps. The lymphadenopathy is limited to the anterior triangle of the neck, is painless, and rarely spreads to other parts. In the second week of the disease, 80% of the hands and feet peel off, which starts from the transition of the nail bed. Some infants and young children may first show perianal desquamation, which requires special attention.

Clinically, high fever (above 39°C) is often the initial manifestation, and the fever lasts for more than 5 days, generally one or two weeks. Some fevers subside for one or two days and then rise again. The fever lasts for three or four weeks, and antipyretics only temporarily reduce the fever. After a few days of fever, the palms and soles become red, swollen and painful, and maculopapular rashes of varying sizes appear on the trunk, with no special shape. They also appear on the face and limbs, without itching, and without herpes or scabs. After a few days of fever, the conjunctivae on both sides are congested, especially the bulbar conjunctivae. Only a few people have purulent conjunctivitis. Anterior iridocyclitis may be found with a slit lamp. The lips are red, swollen, dry and cracked, and even bleeding; the tongue is often bayberry tongue, and the oral mucosa is congested, but there are no ulcers. When there is fever and the eyes, lips and rash are seen, Kawasaki disease can basically be diagnosed.

examine

Two-dimensional echocardiography is suitable for cardiac examination and long-term follow-up. In half of the patients, various cardiovascular lesions such as pericardial effusion, left ventricular enlargement, mitral regurgitation and coronary artery dilatation or aneurysm formation can be found. It is best to check once a week during the acute and subacute stages of the disease. It is the most reliable non-invasive examination method for monitoring coronary artery aneurysms.

In cases of aseptic meningitis, the number of lymphocytes in the cerebrospinal fluid may be as high as 50-70/mm3. In some cases, serum bilirubin or alanine aminotransferase may be slightly elevated. Bacterial culture and virus isolation are both negative.

The above content is an introduction to the diagnosis of Kawasaki disease. The occurrence of this disease brings a lot of harm to children, which is known to parents and friends, so we must pay attention to it and learn more about relevant knowledge. For the sake of children’s physical health, we must do a good job of prevention.