Paediatric- History taking & physical examination of Kawasaki disease (monocutaneous lymph node syndrome)

Paediatric- History taking & physical examination of Kawasaki disease (monocutaneous lymph node syndrome)Created OnApril 22, 2020Last Updated OnApril 22, 2020byadmin You are here: Main Clinical Examination Paediatric- History taking & physical examination of Kawasaki disease (monocutaneous lymph node syndrome) < All Topics Table of Contents History taking: Ask about patient’s information: name, age, gender, ethnicity and ancestry (explore non-modifiable risk factors of Kawasaki disease) Ask about chief complaint – commonly, prolonged fever (usually equal or more than 5 days) Ask about history of presenting illness Fever – ask about the onset, duration, characteristics, recorded temperatures, associated symptoms Ask about the principal features of Kawasaki disease: Extremity changes such as redness of the palms and soles, painful induration of the hands or feet, skin peeling of the fingers and toes Rash and its characteristics and distribution Redness, bleeding, fissuring of the lips, swollen and reddish tongue (strawberry tongue) Conjunctival injection (bilateral, painless, non-exudative) Neck swelling (unilateral, non-purulent cervical lymphadenopathy) ask about other associated symptoms: Irritability Photophobia, neck rigidity, neurological deficits, headaches (aseptic meningitis) Visual disturbance, ocular pain, injection and discharge (uveitis) Hearing loss (otitis media) Chest pain, shortness of breath, palpitation (myocarditis/pericarditis) Cough and shortness of breath (pneumonitis) Scrotal swelling or pain (orchitis) Redness at the BCG vaccination site Diarrhoea, vomiting and abdominal pain (GI involvement) Abdominal pain or distension (hepatosplenomegaly) Ask about systemic review – to assess involvement of other body systems Ask about immunization history ask if the immunizations have been completed based on the national immunization schedule (there may be a need to delay any upcoming attenuated live virus vaccinations as the use of IVIG may decrease the efficacy) Ask about past medical/surgical history Ask about drug history – ask about recent use of drugs such as amoxicillin, trimethoprim, allopurinol, anticonvulsants and certain NSAIDs to rule out drug eruptions Ask about feeding history – ask about food and water intake (the sick child may have poor oral intake which leads to malnutrition and dehydration) Ask about developmental history Ask about family history Physical examination: General examination: look for principal features of Kawasaki disease Assess the vital signs: Elevated temperature Heart rate maybe elevated in acute phase Respiratory rate maybe increased (pneumonitis/cardiac involvement/atypical Kawasaki disease) Oxygen saturation may be low (pneumonitis/respiratory distress syndrome) Pain maybe present due to myocarditis, pericarditis, joint involvement, GI involvement and extremities changes General inspection: Irritable May appear lethargic, drowsy or with altered mental status due to...

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