1/9. Kawasaki disease with reye syndrome: report of one case.A seven-month-old girl was admitted to the pediatrics Department of Mackay Memorial Hospital with the following symptoms and signs: (1) high fever for more than five days; (2) injection of bilateral conjunctiva; (3) bright red lips with strawberry tongue; (4) edematous change of palms and soles, followed by digit desquamation; (5) an ill-defined, erythematous plaque on the scar of the BCG. Kawasaki disease was diagnosed, and high dose aspirin (100 mg/kg/day) and intravenous gamma-globulin (IVIG) (400 mg/kg/day) were given for four days. The patient was afebrile on the second day after IVIG infusion, and was discharged six days after admission. A small single daily dose of aspirin (10 mg/kg/day) was given after the afebrile days. Unfortunately, vomiting and consciousness disturbance were noted one day after discharge. Laboratory data showed elevated aspartate aminotransferase (AST), alanine aminotransferase (ALT) and ammonia. hypoglycemia and prolonged PT and PTT were also noted. reye syndrome was suspected, and the patient was admitted to the intensive care unit for further management. A liver biopsy gave findings consistent with reye syndrome. In spite of intensive treatment, the infant expired on the second day after admission. In a review of the literature, no correlation between these two syndromes was found. This rare case is presented to warn that reye syndrome may follow Kawasaki disease when aspirin has been prescribed at a high dose.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
2/9. Psoriasiform and palmoplanter pustular lesions induced after Kawasaki disease.A 7-month-old boy was referred to us because of psoriatic lesions on the bilateral cheeks and on the extensor region of the left upper arm at the same site of his vaccination for tuberculosis 4 months previously (Fig. 1a,b). He also presented with small pustules scattered on the palms and soles (Fig. 1c).- - - - - - - - - - ranking = 5keywords = palm (Clic here for more details about this article) |
3/9. Kawasaki disease in a 4-year-old boy.A 4-year-old boy experienced sudden fever, followed by a rash on the trunk and extremities and erythema of the pharynx. Five days later, the fever remained and erythema appeared on the oropharynx, tongue, and lips. The skin of the palms and soles became erythematous and indurated, and both conjunctivae became injected. Desquamation of the skin occurred on both thumbs and one finger, and an anterior cervical lymph node was found to be enlarged. The patient was diagnosed as having Kawasaki disease, and treatment with aspirin was started. The desquamation progressed to involve the entire surface of the palms and soles, and then symptoms resolved. Twenty years after recognition of Kawasaki disease, this enigmatic illness continues to defy attempts to understand its etiology and pathogenesis. Most experts agree that the cause is either an environmental toxin or an infectious agent, but other possible causative agents may need to be proposed and investigated.- - - - - - - - - - ranking = 2keywords = palm (Clic here for more details about this article) |
4/9. mucocutaneous lymph node syndrome (Kawasaki disease) in adults.mucocutaneous lymph node syndrome has been reported to occur only in children. Three adults aged 16 to 27 years had findings compatible with this illness. patients with fever, polymorphous skin eruption, congested conjunctiva, reddened palms and soles, red lips and oral mucous membrane, and soft-tissue swelling of the peripheral extremities and who experience membranous desquamation of fingers and toes should be suspected of having mucocutaneous lymph node syndrome. No laboratory test is currently available for confirmation of the diagnosis.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
5/9. mucocutaneous lymph node syndrome. A case masquerading as Rocky Mountain spotted fever.mucocutaneous lymph node syndrome is a recently described entity whose principal signs and symptoms include fever, unresponsiveness to antibiotics, congested conjunctivae, reddening of the oral cavity, lips, palms, and soles, exanthem, edema, nonsuppurative cervical adenitis, and desquamation of the fingertips. Almost 7,000 cases have been reported in japan. Analysis of the 39 cases reported in the united states reveals findings similar to those in japan. united states cases, however, have had a higher boy-to-girl ratio (2:1), and age distribution peaks at a later time (3 years of age). We report a case with many characteristics of rocky mountain spotted fever, including a positive Well-Felix reaction. Some cases of mucocutaneous lymph node syndrome may be misdiagnosed as rocky mountain spotted fever.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
6/9. Toxic shock syndrome. Possible confusion with Kawasaki's disease.Toxic shock syndrome (TSS) is a recently recognized condition associated with toxin-producing strains of staphylococcus aureus. patients affected with this syndrome are frequently young and have multisystemic complaints such as fever, headache, edema, myalgia, scarlatiniform rash, conjunctival injection, confusion, diarrhea, oliguria, hypotension and shock, This is followed by desquamation of the skin, especially the palms and soles. The majority of cases reported have been in menstruating women who used vaginal tampons regularly. Because similarities exist between toxic shock syndrome and Kawasaki's disease (mucocutaneous lymph node syndrome), as well as other conditions, proper diagnosis and management are of the utmost importance.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
7/9. Kawasaki disease in healthy young adult.This report describes a 26-year-old woman who fulfills the criteria for the diagnosis of Kawasaki disease or mucocutaneous lymph node syndrome, an acute febrile illness that usually afflicts young children. The diagnosis is made in persons with fever lasting 5 or more days when four of the following criteria are met: bilateral injection of ocular conjunctivae; the involvement of the mucous membranes of the upper respiratory tract consisting of any combination of the following--redness and fissuring of lips; "strawberry tongue," or erythema of the pharynx; involvement of the peripheral extremities characterized in the early stages by an indurative erythematous rash of palms and soles followed by membranous desquamation; polymorphous nonvesicular truncal exanthem; and acute nonsuppurative enlargement of cervical lymph nodes. An added stipulation is that the illness must not be attributable to a known disease process.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
8/9. Kawasaki syndrome. An important consideration in the febrile child.Many aspects of Kawasaki syndrome remain a mystery. The cause of the disease has eluded researchers, and its pathophysiology is a subject of much debate. However, the diagnostic features have been identified: A significant fever for at least 5 days, bilateral nonexudative conjunctivitis, erythema of the palms and soles, a polymorphic diffuse rash, cervical lymphadenopathy, and injection of the mouth and oropharynx. The recently instituted treatment protocol of high-dose aspirin with gamma globulin (Gamastan, Gammar) helps patients recover more quickly and with fewer potentially life-threatening sequelae than does aspirin alone.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
9/9. Ischemic heart disease 31 years after possible Kawasaki disease.We present a 38-year-old woman who had experienced an acute febrile illness lasting more than 1 week at the age of 6, with erythema on the palms and soles following skin desquamation in the subacute phase and skin eruption. Thirty one years later, she experienced acute myocardial infarction and episodes of angina pectoris. She had no coronary risk factors or autoimmune diseases. coronary angiography revealed an aneurysm of the proximal left coronary artery with occluded lesions at the distal site. The right coronary artery was also occluded at the proximal site. These findings strongly suggest Kawasaki disease should be considered in the differential diagnosis of early-onset ischemic heart disease in young adults.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |