Pediatric emergency medicine trisk 3012 3012

albumin ≤3 g/dL, anemia for age, elevated alanine aminotransferase, platelets
≥450,000/mm3 after 7 days of illness, white blood cell count ≥15,000/mm3, and urine
≥10 white blood cells per high-power field. If the child has more than three
supplemental laboratory criteria, and a positive echocardiogram ( Table 101.19 ), then
treatment for KD is recommended. In children with fewer than three supplemental
laboratory criteria and a negative echocardiogram, KD is unlikely, but serial clinical
and laboratory re-evaluation is recommended if fevers persist.
TABLE 101.18
CLINICAL FINDINGS CONSISTENT WITH KAWASAKI DISEASE
Cardiovascular findings
Congestive heart failure, myocarditis, pericarditis, valvular regurgitation
Coronary artery abnormalities
Aneurysms of medium-size noncoronary arteries
Raynaud phenomenon
Peripheral gangrene
Musculoskeletal system
Arthritis, arthralgia
Gastrointestinal tract
Diarrhea, vomiting, abdominal pain
Hepatic dysfunction
Hydrops of gallbladder
Central nervous system
Extreme irritability
Lethargy
Aseptic meningitis
Sensorineural hearing loss
Genitourinary system
Urethritis/meatitis
Other findings
Erythema, induration at Bacille Calmette–Guerin (BCG) site
Anterior uveitis (mild)

Desquamating rash in groin
It should be noted that special consideration is given to febrile infants ≤6 months of
age. It is recommended that these young infants have a baseline echocardiogram if
febrile for 7 days or longer, even if there are no other clinical manifestations of KD
present. If the echocardiogram is positive ( Table 101.19 ), then treatment is started. If
the echocardiogram is negative, then supplemental laboratory studies should be