Pediatr. praxi. 2025;26(2):122-125 | DOI: 10.36290/ped.2025.023
A complicated way to an unexpected diagnosis
- 1 Dětské lékařství, Městská nemocnice Ostrava a Klinika dětského lékařství, Fakultní nemocnice Ostrava, Lékařská fakulta, Ostravská univerzita
- 2 Ústav farmakologie LF UP a FN Olomouc
A 4-year-old boy with a previously unremarkable medical history was admitted for cervical lymphadenopathy and fever. From the 3rd day of hospitalization a small-papulous exanthema and abdominal pain for which laparoscopic revision was necessary, phlegmonous appendicitis was found, and appendectomy was performed. Antibiotic treatment was repeatedly changed for suspected toxoallergic exanthema. Despite broad-spectrum antibiotics, inflammatory markers, transaminases continued to rise, lymphadenopathy did not significantly regress, exanthema, febrile persisted, conjunctivitis, chapped lips, arthralgia appeared. Differential diagnostic consideration was given to EB virosis, parainfectious exanthema, Kawasaki syndrome was suspected. Despite of negative findings on cardiological examination the treatment with one dose of intravenous immunoglobulins (IVIG) and acetylsalicylic acid (ASA) was administered. After administration of IVIG followed prompt decrease in temperature, regression of exanthema, nodal syndrome, normalization of laboratory findings. We concluded as Kawasaki syndrome.
Keywords: fever, lymphadenopathy, Kawasaki syndrome, intravenous immunoglobulins.
Accepted: May 2, 2025; Published: May 6, 2025 Show citation
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