rubyedward
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kawasaki d/s- fever more than 5 days- even after aspirin, fever not resolved, pealing exanthema rash, swollen hands, unilateral cervical lymphadenopathy, inc ESR. Rx with aspirin and IG. i think child looks more toxic in KD than scarlet fever.
scarlet fever- sand paper like rash, aspirin helps reduce fever.
they both have strawberry tongue.
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| chemamr
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scarlet fever - Also circumoral pallor, pastia lines, exudative tonsillitis 
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| Vai
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rubyedward Posted Jun 22, 05 - 06:24:
kawasaki d/s- fever more than 5 days- even after aspirin, fever not resolved, pealing exanthema rash, swollen hands, unilateral cervical lymphadenopathy, inc ESR. Rx with aspirin and IG. i think child looks more toxic in KD than scarlet fever.
scarlet fever- sand paper like rash, aspirin helps reduce fever.
they both have strawberry tongue.
what if in exam say: is at 5th day of fever, pealing rash exist also in scarlet, lymphadenopathy and high ESR in scarlet( is an infection) and elevated ESR in kawasaki in acut phase (normal in convalescent), the aspirin didn't receive(afraid of Reye), disseminated strep infection can look very toxic and kawasaki look ill but not toxic; yes swollen hands are something (but if you think that strep can give some nephritic with mild edema, this fall to), also kawasaki have sand paper like rash.
Chemamr point good on pastia line and circumoral pallor( i don't know what it is), injected pharynx and mucosa exist also in K disease (truly exudat no, but is confoundable). Other things are miliary sudamina in scarlet, abrupt onset of fever headache, abd. pain and vomiting in scarlet, positive strep throat, and very important CONJUNCTIVAL INVOLVEMENT ONLY IN KAWASAKI.
if i'm wrong please correct
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| drvic
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diagnostic criteria for Kawasaki are:
fever of atleast 5 days' duration along with atleast four of the follwing features
a) bilateral conjunctival congestion
b) congested oropharynx, strawberry tongue etc.
c) edema and erythema of hands
d) truncal rash
e) cervical LN.
inspite of these diagnostic criteria, there are no clear cut things in medicine and there can be times when a diagnostic dilemma can exist.
however, rash of scarlet fever is quite distinct and i think it clinches the diagnosis in almost all situations clinically. it has very sharply demarcated margins and is bright red to scarlet in colour. not so in kawasaki. other investigations are adjunctive. so if you've seen a case of scarlet fever, you won't forget it for the rest of your life...i've seen two typical ones...
pastia's lines are non-specific - they are also seen in atopic dermatitis
so is there any confusion still left - even if you apply these diagnostic criteria? if there is - let me know.
hope this helps
regards
drvic
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