8 year Old just diagnosed for KD and treated

[bkfillmore]

Hello,

My daughter who is 8 years old was just diagnosed June 4, 2018 for Kawasaki Disease. Her symptoms were questionable if she met the criteria but they chose to treat it as KD. After the treatments her fevers subsided.
Her presentation and history are the following:

Birth:
In vitro
IUGR
Born 33 weeks at 1300 grams
Feeding intolerances during NICU stay but recovered well.

Relevant History:
Chronic constipation since infancy
Recurring UTIs (query???) since Aug 2016 - doctors claim classic symptoms of UTI (bed-wetting, back pain, pain urinating, presence of E. coli in urine) but cultures would not confirm bacterial culture. Continuously on antibiotics but symptoms always resurface within 4 weeks of finishing antibiotics
Annual ear infection
Recent diagnosis of Celiac Disease (Stage 3 b)

Symptoms leading to KD diagnosis:
High grade fever and chills
CRP (Creatine Reactine Protein) was 300
Chills - she would go ghost white with blue under her eyes and mottled skin.
Fever and Chills didn't improve with 2 course of antibiotics and poorly controlled with ibuprofen and Acetaminophen
During Fever - lips and gums go cherry-red, rash that disappeared with use of ibuprofen, NO peeling of hands or feet
Presence of swollen lymph nodes
Complaints of sore neck and sore throat
Last 24 hours of symptoms developed green nasal discharge from sinus

Treatment included;
IV infusion of Immunoglobulins first few hours of diagnosis
High dose of Aspirin over 48 hours

Reaction to Treatment:
Fever, Severe pulsating headache to forehead region in middle of night, significant vomiting and spontaneous nose bleeds that stopped once pressure applied

Nurse provided Zofran via IV to control nausea and Tylenol for headache and fever and she got 6 solid hours of sleep and slept the remainder of the day

She has been fever free for 24 hours and discharged. Her CRP level dropped to 150 and Echo to heart was good but developing spontaneous nose bleeds since at home for last 6 hours. She just started to show signs of peeling palms. She has been reduced to 180 mg aspirin daily for 6 weeks and followup with cardiologist.

We are very appreciative with the consults and intense chart reviews for the doctors to decide to treat her for KD as we were very convinced she had at least 4 of the signs and symptoms of KD. We hope the nose bleeds subside and we are worry free moving forward.

[dtango90]

Glad to hear the good report on your daughter. Glad they diagnosed it as KD. We are finding out that they typical case of KD is atypical (as one of the head Dr's involved with our daughter told us)! How long was your daughter ill be fore they diagnosed it?

Our daughter had been ill 6 days before KD diagnosis (admitted & diagnosed Jun 13). She was definitely an atypical KD case. She only had fever for 4 days, but had a number of the other symptoms but not at the same time (rash, swollen red cracked blood lips, red eyes, hands and feet swelling, very tired and lethargic, labs that showed slight inflammation going on). Thankfully the Rheumatologists who got involved called it as KD while everyone else didn't, primarily because she didn't have a fever when we admitted her. The IVIG did wonders for her.