Topic: Virus kawasaki

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Kawasaki disease is a condition that causes inflammation in the walls
of small- and medium-sized arteries throughout the body, including the
coronary arteries. It mostly affects children from ages 2 to 5.
Identified by a Japanese doctor, Tomisaku Kawasaki, in 1967, Kawasaki
disease is also called mucocutaneous lymph node syndrome because it
also affects lymph nodes, skin and the mucous membranes inside the
mouth, nose and throat.

Kawasaki disease occurs more often in boys than girls, and most
commonly in children of Japanese or Korean descent, although any child
can get it. It can cause serious complications of the heart and the
blood vessels that supply the heart. Some of the complications of
Kawasaki disease may be life-threatening.

The condition is not preventable, but it's treatable in most cases.
Most children recover from Kawasaki disease without serious problems.

Signs and symptoms
The signs and symptoms of Kawasaki disease appear in phases.

First phase
The first phase begins with a fever, which often is higher than 104 F
(39 C), spikes and remits, and lasts one to two weeks. Your doctor may
suspect Kawasaki disease if the fever lasts for five or more days, and
your child has developed four or more of these signs and symptoms:

Extremely red eyes (conjunctivitis) without thick discharge
A rash on the main part of the body (trunk) and in the genital area
Red, dry, cracked lips and an extremely red, swollen tongue
("raspberry" tongue)
Swollen, red skin on the palms of the hands and the soles of the feet
Sore throat
Swollen lymph nodes in the neck and perhaps elsewhere
Second phase
In the second phase of the disease, your child may develop:

Peeling of the skin on the hands and feet, especially the tips of the
fingers and toes, often in large sheets
Joint pain
Abdominal pain
Third phase
In the third phase of the disease, signs and symptoms slowly go away
unless complications develop.

No one knows what causes Kawasaki disease. A number of theories link
the disease to bacteria, viruses, or environmental chemicals or
pollutants, but none has been proved. Kawasaki disease doesn't appear
to be hereditary.

When to seek medical advice
Most children with Kawasaki disease recover with no problems, with or
without treatment. However, the disease can cause serious heart
problems and joint damage. Treating Kawasaki disease within 10 days of
its onset may greatly reduce the chances of lasting damage. It's
important to contact your child's doctor if your child has signs or
symptoms of this disease.

Screening and diagnosis
There's no specific test available to diagnose Kawasaki disease.
Diagnosis largely is a process of ruling out diseases that cause
similar signs and symptoms, including:

Scarlet fever, which is caused by streptococcal bacteria and results
in fever, rash, chills and sore throat
Juvenile rheumatoid arthritis
Stevens-Johnson syndrome, a disorder of the mucous membranes
Toxic shock syndrome
Cytomegalovirus or Epstein-Barr virus infection
Your doctor may conduct a physical examination and have your child
undergo other tests to aid in the diagnosis. These tests may include:

Urine tests. These tests help rule out other diseases.
Blood tests. Besides helping to rule out other diseases, blood tests
look at white blood cell count, which is likely to be elevated, and
the presence of anemia and inflammation, indications of Kawasaki
Electrocardiogram. This test uses electrodes attached to the skin to
measure the electrical impulses of your child's heartbeat. Kawasaki
disease can cause serious complications of the heart.
Echocardiogram. This test uses ultrasound images to show how well the
heart is functioning and provides indirect evidence on how the
coronary arteries are functioning.

Kawasaki disease is the leading cause of acquired heart disease in
children. About one in five children with the disease develops heart
problems, but fewer than half of them will have permanent damage.

Heart complications include:

Inflammation of the heart muscle (myocarditis)
Enlargement of the heart (cardiomegaly)
Abnormal heart rhythm (arrhythmia)
Inflammation of blood vessels (vasculitis) , usually the coronary
arteries, which supply blood to the heart
Any of these complications can cause your child's heart to
malfunction. Inflammation of the coronary arteries can lead to
aneurysms (weakening and bulging of the artery wall). Aneurysms
increase the risk of blood clots forming and blocking the artery,
which could lead to a heart attack or cause life-threatening internal

For a small percentage of children who develop coronary artery
problems, Kawasaki disease is fatal, even with treatment.

Your doctor will want to begin initial treatment for Kawasaki disease
as soon as possible after the appearance of signs and symptoms,
preferably while your child still has a fever. The goals of initial
treatment are to lower fever and inflammation and prevent heart

To accomplish those goals, your child's doctor may recommend:

Aspirin. High doses of aspirin can reduce the fever, rash, joint
inflammation and pain and help prevent blood clots from forming.
Gamma globulin. Infusion of gamma globulin (an immune protein) through
a vein (intravenously) can lower the risk of coronary artery
Because of the risk of serious complications, initial treatment for
Kawasaki disease usually is given in a hospital.

After the initial treatment
Once the fever subsides, your child may need to take low-dose aspirin
for at least six to eight weeks, and longer if he or she develops a
coronary artery aneurysm. Aspirin helps prevent clotting.

However, if your child develops flu or chickenpox during treatment, he
or she will need to stop taking aspirin. Taking aspirin has been
linked to Reye's syndrome, a rare but serious illness that can affect
the blood, liver and brain of children and teenagers after a viral
infection. (This is another reason to immunize your child on schedule
against chickenpox.)

Without treatment,
Kawasaki disease can last from two to 12 weeks.
With treatment, your child may start to improve within 24 hours.

Monitoring heart problems
If your child has any indication of heart problems, your doctor may
recommend follow-up tests to monitor heart health at regular
intervals. If your child develops continuing heart abnormalities, your
doctor may refer you to a doctor who specializes in treating heart
disease in children (pediatric cardiologist) . In some cases, a child
with a coronary artery aneurysm may require:

Anticoagulant drugs. These medications, such as aspirin, warfarin and
heparin, help prevent clots from forming.
Coronary artery angioplasty. This procedure opens arteries that have
narrowed to the point that they impede blood flow to the heart.
Stent placement. This procedure involves implanting a device in the
clogged artery to help prop it open and decrease the chance of
re-blockage. Stent placement often accompanies angioplasty.
Coronary artery bypass graft. This operation involves rerouting the
blood around a diseased coronary artery by grafting a section of blood
vessel from the leg, chest or arm to use as the alternate route.

Coping skills
Find out all you can about Kawasaki disease so that you can make
informed choices with your child's health care team about treatment
options. Keep in mind that most children with Kawasaki disease recover
completely within the first six months after they begin treatment.

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Topic: Virus kawasaki

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Topic: Virus kawasaki

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