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Child with fever and a rash

Child with fever and a rash PATIENT PRESENTATIONA previously healthy 9‐month‐old Asian male presented to the emergency department with 3 days of fever and rash. The rash had begun on his buttocks, then spread to his trunk and extremities (Figures 1 and 2). His mother noted his hands and feet appeared red and swollen over the previous 2 days (Figure 3), and that his tongue appeared unusually red with some fine vesicles and cracking of his upper lip (Figure 4). Cervical lymphadenopathy was noted on physical examination. Laboratory results included a serum white blood cell count of 18,400/mm3, an elevated C‐reactive protein and erythrocyte sedimentation rate of 71 mg/dL and 63 mm/h respectively, and urinalysis with 58 WBCs/hpf.1FIGURERash on buttocks and torso.2FIGURERash on the lower extremities.3FIGUREErythema and edema of the hands and feet.4FIGUREStrawberry appearance of the tongue with fine vesicles and cracking of the upper lip.  DIAGNOSISKawasaki diseaseKawasaki disease is an acute systemic vasculitis with a predilection for the coronary arteries that most commonly affects children of Asian or Pacific Islander descent that are <5 years old.1–3 Kawasaki disease is a clinical diagnosis based on the presence of fever for 5 days combined with at least 4 of the following features: oral changes including strawberry tongue or erythema and cracking of the http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of the American College of Emergency Physicians Open Wiley

Child with fever and a rash

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References (9)

Publisher
Wiley
Copyright
© 2023 American College of Emergency Physicians.
eISSN
2688-1152
DOI
10.1002/emp2.12932
Publisher site
See Article on Publisher Site

Abstract

PATIENT PRESENTATIONA previously healthy 9‐month‐old Asian male presented to the emergency department with 3 days of fever and rash. The rash had begun on his buttocks, then spread to his trunk and extremities (Figures 1 and 2). His mother noted his hands and feet appeared red and swollen over the previous 2 days (Figure 3), and that his tongue appeared unusually red with some fine vesicles and cracking of his upper lip (Figure 4). Cervical lymphadenopathy was noted on physical examination. Laboratory results included a serum white blood cell count of 18,400/mm3, an elevated C‐reactive protein and erythrocyte sedimentation rate of 71 mg/dL and 63 mm/h respectively, and urinalysis with 58 WBCs/hpf.1FIGURERash on buttocks and torso.2FIGURERash on the lower extremities.3FIGUREErythema and edema of the hands and feet.4FIGUREStrawberry appearance of the tongue with fine vesicles and cracking of the upper lip.  DIAGNOSISKawasaki diseaseKawasaki disease is an acute systemic vasculitis with a predilection for the coronary arteries that most commonly affects children of Asian or Pacific Islander descent that are <5 years old.1–3 Kawasaki disease is a clinical diagnosis based on the presence of fever for 5 days combined with at least 4 of the following features: oral changes including strawberry tongue or erythema and cracking of the

Journal

Journal of the American College of Emergency Physicians OpenWiley

Published: Apr 1, 2023

Keywords: Childhood vasculitis; Kawasaki; Kawasaki disease; Kawasaki's disease; Systemic vasculitis; Vasculitis

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