11: 4-year-old male with fever and adenopathy Flashcards
What’s the normal HR for a 4-year-old?
65-135
What are 4 causes of unilateral cervical lymphadenopathy?
- Reactive cervical adenitis
- Kawasaki disease
- Bacterial cervical adenitis
- Cat scratch disease
- Mycobacterial infection
Which cause of unilateral cervical lymphadenopathy causes nonfluctuant lymph node?
Kawasaki disease
Which cause of unilateral cervical lymphadenopathy is typically seen in kids age 1-5 with a recent URI and is usually Staph or Strep?
Bacterial cervical adenitis
Which cause of unilateral cervical lymphadenopathy causes axillary LAD and is caused by Bartonella and is usually self-limiting?
Cat scratch disease
Which cause of unilateral cervical lymphadenopathy causes erythematous and violacious overlying skin, rupture of lymph nodes, and must be treated by surgical excision?
Mycobacterial infection
What 3 diseases can result in Strawberry Tongue?
- Strep pharyngitis
- Kawasaki disease
- TSS
Four out of what 5 criteria are necessary for a diagnosis of Kawasaki disease?
- Oral mucosa changes
- Extremity redness/swelling
- Unilateral cervical LAD
- Rash
- Conjunctivitis
What are the 3 phases of Kawasaki disease and how long does each last?
- Acute (10 days)
- Subacute (10 days-3 weeks)
- Convalescent (3 weeks-8 weeks)
What are the findings in the acute phase of Kawasaki disease?
Fever, systemic inflammation, acute phase reactants
What are the findings in the subacute phase of Kawasaki disease?
Fever and clinical findings subside; feet and hands peel
What are the findings in the convalescent phase of Kawasaki disease?
Just serologic evidence of inflammation persists
What heart issue can happen as a result of Kawasaki disease?
Coronary artery aneurysm
What’s the best treatment for Kawasaki disease?
High dose aspirin (80-100mg/kg/day) divided into 4 doses, plus IVIG (2 g/kg) over 10-12 hours
When is the most likely time of coronary artery aneurysm in Kawasaki disease?
4 weeks
Would a negative ESR indicate Kawasaki disease?
No, ESR is usually elevated in Kawasaki disease
What are the liver enzyme and albumin levels in Kawasaki disease?
Liver enzymes: high
Albumin: low
What’s the progression of Measles rash?
Starts on neck behind ears, spreads downward
What’s the progression of the RMSF rash?
Starts on ankles and wrists and progresses centrally and to palms and soles
What’s the progression of the Scarlet fever rash
Begins at neck, axillae, and groin, and then spreads over trunk and extremities
What’s the progression of the Varicella rash?
Starts on trunk and spreads to extremities and head
What’s the progression of Erythema infectiosum rash?
Starts as slapped cheeks and spreads to the trunk and extremities
What’s the progression of Roseola rash?
Starts on trunk and spreads to arms and neck; less commonly face and legs
Erythema infectiosum vs. Roseola?
Roseola has a high fever, erythema infectiosum has a low fever
What group of strep causes Scarlet fever?
GAS
How long does Kawasaki fever have to be minimum?
5 days
