CASE STUDY: KAWASAKI DISEASE

Patient RD 2 years old female came in 3/6/22 due to on and off high grade fever X 5 days with
eye redness, and redness of the mouth and tongue under the service of Dr. Nolasco.

HPI
5 days prior to admission, the patient develops high grade fever (38.5-40 degrees celsius)
without other symptoms noted. She was brought to a private clinic for a consult wherein (+)
redness in the tonsils were noted upon examination. CBC and urinalysis was also checked.
Significant findings for the CBC were prominent lymphocytes and 170 for the platelet. In the
urinalysis was the presence of a 8-10 in the pus cells. The patient was prescribed with
Co-Amoxiclav (Natravox) 156.25mg/5ml 5ml BID X 7 days and repeat CBC was also ordered.
initial findings of SVI to R/O DF.
On day 2-3, there was still a high grade fever. CBC was within normal range, previous
prescribed treatment was continued as advised to them of the pediatrician.
On day 4, maculopapular rash was noted on the trunk and extremities still accompanied by
high grade fever. The patient was advised for covid-19 RT PCR testing prior to admission in the
hospital.
On day 5,the patient’s result of negative RT PCR was released and the patient was brought to
MDH for admission due to persistent fever, rash accompanied this time by eye redness, redness
of the tongue and mouth. Diagnosis: T/C Kawasaki Disease

PAST MEDICAL HISTORY

The patient was the youngest of 2 from her G2P2 mother and was born via CS due to CPD.
According to her mother the patient rarely gets sick since her child is completely vaccinated for
her age and has not encountered any accident.

FAMILY HISTORY
Patient’s mother has allergic rhinitis with no other comorbidities while the father is diagnosed
with hypertension.
MATERNAL SIDE: + history of CA (grandmother) DM (grandfather) allergic rhinitis (mother’s
siblings)
PATERNAL SIDE: both grandmother and grandfather have DM and heart disease.

PERSONAL HISTORY:
The patient is an active child who loves to play with her pet dog in the park and enjoys playing
and watching video with her ipad.
LABS:
CBC 5 DAYS BEFORE ADMISSION

NORMAL VALUE RESULT

Hemoglobin 11 10.2-12.7

Hematocrit 36 31.2-37.8

RBC 4 3.84-4.92

WBC 7.4 4.9-13.2

Neutrophil 7.85 1.6-8.29

Lymphocytes 6.3 1.25-5.77

Platelet 178 184-394

CBC 4 DAYS BEFORE ADMISSION

NORMAL VALUE RESULT

Hemoglobin 12.3 10.2-12.7

Hematocrit 40.5 31.2-37.8

RBC 4.64 3.84-4.92

WBC 10 4.9-13.2

Neutrophil 3.7 1.6-8.29

Lymphocytes 5.21 1.25-5.77

Platelet 197 184-394

CBC (DAY OF ADMISSION)

NORMAL VALUE RESULT

Hemoglobin 10.2-12.7

Hematocrit 31.2-37.8

RBC 3.84-4.92

WBC 4.9-13.2

Neutrophil 1.6-8.29

Lymphocytes 1.25-5.77

Platelet 184-394

URINALYSIS 5 DAYS BEFORE ADMISSION

CRP (ADMISSION)- 26.8 mg/l

ESR (ADMISSION)- 78mm/h
TOTAL BILIRUBIN- 3 mg/dl
ALBUMIN- 3 g/dl
AST- 150 U/L
ALT- 75 U/L

CHEST XRAY: Normal chest findings

2DECHO: showed mild coronary artery dilatation

*For the management refer to the endorsement made last Mar 9, 2022 .