Editing Pediatric Nursing (section)

=== Kawasaki disease ===

An acute vasculitis of young children. Classic criteria are '''fever lasting 5 or more days''' plus at least four of: '''bilateral non-exudative conjunctivitis; oral changes including strawberry tongue and cracked lips; polymorphous rash; extremity changes with erythema and edema of the hands and feet followed by periungual peeling; and unilateral cervical lymphadenopathy'''. The child is characteristically extremely irritable.

'''Application note.''' The danger is '''coronary artery aneurysm'''. Treatment is '''intravenous immunoglobulin plus aspirin''', and echocardiography is obtained at baseline and in follow-up. Kawasaki disease is one of the few pediatric indications for aspirin. Because IVIG contains live-virus antibodies, '''live vaccines such as measles-mumps-rubella and varicella must be deferred for about 11 months''' after high-dose IVIG.