Concluded Case

18/f h/o fever three days rashes, joint pains severe dehydration. strawberry tongue? wht could b the diagnosis and treatment?

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pt diagnosed as Kawasaki disease pt clinically and diagnostic procedures brought to conclusion of Kawasaki disease. pt treated symptomatically with antibiotics, anticoagulant, corticosteroid now general conditions improved.
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In my opinion the case would be Dengue haemorrhagic fever, but h//of fever must be not less than 4 days, as febrile stage lasts for 4 days, then critical phase from 4th to 7th day, then recovery stage. And obviously now the season has come for Dengue. BP & Pulse not told, in critical stage of haemorrhagic fever clinically pressure calf tourniquet test is positive more than 20 patichiae per square inch in forearm. Pulse pressure >=20, PCV>45 indicates plasma leakage & tachycardia. IV Fluid Crytalloids & Colloidal ie NS, RL & Dextran 40,easy availability may start, initially RL/NS 10ml/kg/hour followed by Dextran40, after 2 hours asses dehydration, if improves gradually tapper 7ml, 6ml, 3ml not more than 48 hours. Intropin may require to increase BP. Do PCV & Platelet count twice daily. If platecount comes below 10000 then think for blood/platelet. DD Scarlet fever Kawasaki disease Viral exanthem
RAJEEV GAUTAM BHABHUA@
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Check for other signs and symptoms of kawasaki disease before labelling the same Bilateral nonsuppurative conjunctivitis One or more changes of the mucous membranes of the upper respiratory tract, including throat redness, dry cracked lips, red lips, and "strawberry" tongue and one or more changes of the arms and legs, including redness, swelling, skin peeling around the nails, and generalized peeling,Polymorphous rash, primarily truncalLarge lymph nodes in the neck (>15 mm in size) Criteria from Nelson. ESR CRP and 2D echo will assist Rx High dose of aspirin and ivig
Valuable opinion
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DD VIRAL EXANTHEME DD Kawasaki disease, since the complications of this disease includes coronary artery disease, we should have high index of suspicion, and investigate to rule out this DD. DD Antibiotic induced glossitis
Kindly dont stick to Strawberry tongue.... Update propwr history with clinical findings...which will make diagnosis not merely images
Small to medium vessels vasculitis. Advice CRP, ESR, Platelets, ECG /Echo. Rx : Steroid / Immunoglobulin. Aspirin.
D/D.. * VIRAL FEVER.. * DENGUE.. * KAWASAKI DISEASE.. * SCARLET FEVER.. NEED'S CLINICOPATHOLOGICAL EVALUATION..
Tnx
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Kawasaki disease
Kawasaki disease
Kawasaki ds
pt diagnosed as Kawasaki disease pt clinically and diagnostic procedures brought to conclusion of Kawasaki disease. pt treated symptomatically with antibiotics, anticoagulant, corticosteroid now general conditions improved.
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