Paucis Verbis: Kawasaki Disease

Kawasaki_diseaseKawasaki Disease can be easy to diagnose when you have the pediatric patient, who presents with all 5 of the classic clinical findings. What happens when you have the prerequisite fever for ≥5 days, but only 2-3 clinical criteria?

  • What ARE the 5 classic findings?
  • When do you do waitful watching?
  • When do you perform an echo?
  • When do you treat empirically?

Check out the nice flowchart below which addresses these questions. They summarize the most recent (2004) American Heart Association’s consensus group’s recommendations.

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2017-08-01T23:52:10-08:00

Paucis Verbis: Fever without a source (29 days-3 months old)

ThermometerIn part 2 of this “Pediatric Fever Without a Source” Paucis Verbis cards, we now cover febrile infants aged 29 days to 3 months (PV card for birth-28 days). Note that there is no single correct answer in how to manage these patients. There can be a wide variation in practices, partly because of the slightly different criteria used by the 3 studies. The overarching principle is that “high risk” infants get admitted with IV ceftriaxone and “low risk” infants get discharged with close follow-up +/- a ceftriaxone IV or IM dose. The line between these two risk categories is the grey area.

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2017-08-03T00:45:34-08:00

Trick of the Trade: Pediatric ear exam

ChildEaraches2

Performing a physical exam on frightened pediatric patients can often be challenging. I am always thrilled to add more child-whisperer techniques to my arsenal of tricks. I have written in the past about:

What’s your trick on performing an otoscope exam of the ears?

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2019-02-19T18:08:03-08:00