11- fever, adenopathy Flashcards
range of HR for 4 year old
65 to 135
differential for fever and rash in 4 year old
A. Adenovirus infection B. Kawasaki disease C. Meningococcemia D. Measles E. Rocky Mountain spotted fever F. Scarlet fever G. Stevens-Johnson syndrome H. Enteroviral infection I. Varicella J. Erythema infectiosum K. Roseola
unilateral cervical lymphadenopathy:
Reactive cervical adenitis- infection
response
Kawasaki disease
Bacterial cervical adenines
Cat scratch disease
Mycobacterial infection
Infectious Causes of Generalized Lymphadenopathy
Measles Infectious mononucleosis-EBV or CMV Human immunodeficiency virus (HIV) Histoplasmosis Toxoplasmosis Mycobacteria
Non-Infectious Causes of Generalized Lymphadenopathy
Lymphomas Leukemia Histiocytosis Metastatic neuroblastoma Rhabdomyosarcoma
strawberry tongue diseases
Streptococcal pharyngitis
Kawasaki disease
Toxic shock syndrome
common ages for kawasaki
15-18 months old
kawasaki phases
Acute phase: ~10 days. Fever, rash, elevated acute phase reactants
Subacute phase: 10 days - ~3 weeks. Fever resolves and clinical findings largely subside (often with peeling of hands and feet). Serologic evidence of inflammation continues.
Convalescent phase: 3 weeks - 6-8 weeks. All clinical findings have resolved. Continued serologic evidence of inflammation.
kawasaki complications
coronary art aneurysm- do echo- by 4 wks aseptic meningitis liver dysfunction arthritis hydrous of gallbladder
kawasaki labs
CBC: high WBCs-PMNs, normocytic normochromic anemia, thrombocytosis
liver enzymes high, albumin low
positive ESR and CRP
sterile pyuria
kawasaki treatment
low dose aspirin for 6-8 wks+ IVIG
Cat scratch disease
Bartonella henselae
asymptomatic or symptomatic.
introduced by a scratch from a cat with subsequent infection of the node or nodes draining that site.
The site most commonly involved is the axilla, followed by cervical, submandibular, and inguinal areas.
Usually a self-limited disease, with regression of the lymph node in four to six weeks.
scarlet fever rash
group a strep
A diffuse, erythematous, finely papular rash (described as having a “sandpaper” texture) is pathognomonic
Rash often begins at neck, axillae, and groin and then spreads over trunk and extremities, typically resolving within four or five days
roseola rash
erythematous macules start on trunk and spreads to arms and neck (less commonly face and legs)
Rash is typically preceded by 3-4 days of high fevers, which end as the rash appears
Usually occurs in children under age 2 years
