Kawasaki Disease: The Ali Chronicles - Symptoms to Watch Out For

Note: This entry is not meant to replace professional medical advice. Please consult with your child's physician if your child is sick or has high-grade fever.

When Ali first had a fever that weekend, I thought it was just one of those viral things although it was strange that her fever was pretty high (39-40 degrees celsius). She did not have any cough or colds but she was complaining that her neck (her throat, I guess)was itchy or painful and this was the first time she did this in all of her two years.

We took her to her pediatrician on the 2nd day of her fever and she was prescribed a certain kind of antibiotic for her swollen tonsils. That night (Tuesday, June 15), she started to have small rashes on her butt which looked like her usual diaper rash. She, however, started to throw up everything she took in.

June 16, Wednesday, in the morning, I noticed that Ali's palms were quite red, same with the soles of her feet. Her rashes - in the diaper area - had also grown larger - and now appeared to be connecting with each other. Some rashes had also appeared on her legs and arms. Thinking that it might be dengue, I texted her doctor who instructed me to bring her to the ER to have her examined further.

Upon arriving at the ER and after being examined, it was recommended that she be confined to prevent dehydration - as she was hardly eating or drinking and threw up the little that she took in. The initial diagnosis was: severe viral exanthem - or some viral infection with skin manifestations. At that time, we were told that we would have to stay in the hospital for 2-3 days for observation.

The 2-3 days turned into 2 weeks. As I will discuss in future entries, Ali was diagnosed to have Kawasaki Disease. The doctors say we are quite lucky (isn't it great that even as we get sick - there is a positive side?) as Ali's symptoms appeared in 2 days, unlike other patients who may take a week to manifest - and in which case, the doctors cannot take appropriate action.

Based on my understanding, a patient must have 5 out of 6 symptoms to be diagnosed as having Kawakasaki. The symptoms, as I remember from what Ali's doctors have discussed are as follows:

1. High-grade fever: in the 39-40 degree celsius range and which does not respond for long to paracetamol

2. Swollen lymph nodes

3. Rashes - which usually start in the extremities or diaper area - then going on to the trunk and the other parts of the body. In Ali's case the rashes were circular or elongated (not like the pin-prick rashes of dengue) and very red. She even had a mask-like rash on her face - around the eyes, the nose, and the mouth - making her look like Spider Baby.

4. Eyes - they redden as if with conjunctivitis or sore eyes

5. The lips and the mouth dry up - and they darken from wounds/dryness

6. Swelling of the hands and feet

After the disease has gone on for some time, the skin on the fingers, toes/feet will peel - and I mean really peel - with skin actually hanging. Doctors also say that the joints are quite painful - as if the patient has arthritis so in some cases, the kids don't like to walk or to move.

Next, we shall talk of the diagnostic tests during and after discharge. In any case, intuition on the parent's part is really key. If you feel that something is wrong with your child, do not hesitate to consult your doctor. It is best to err on the side of safety than to be sorry for not taking appropriate action early enough.

[By Angelica Viloria | Monday, August 9, 2004]


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