Diagnosis and Management of Kawasaki Disease.
1.IVIG prevents the development of coronary aneurysms in a dose-dependent fashion. A single dose of 2 g per kg is administered within 10 days of illness.
2.high-dose aspirin, 80 to 100 mg per kg per day in four divided doses, until the patient is afebrile for 48 to 72 hours (some recommend continuing until the 14th day of illness has also passed). Afterward, low-dose aspirin at 3 to 5 mg per kg per day is given as a single dose until six to eight weeks after disease onset.
3.Approximately 10% of patients have refractory disease that does not respond to initial therapy (i.e., fever persists or recurs 36 hours after initial IVIG dose). These patients usually receive a second infusion of IVIG at 2 g per kg. The AHA guideline states that the relative roles of repeated use of IVIG and other adjunctive therapies (e.g., corticosteroids, TNF-ฮฑ antagonists, plasma exchange, cyclophosphamide).
1.IVIG prevents the development of coronary aneurysms in a dose-dependent fashion. A single dose of 2 g per kg is administered within 10 days of illness.
2.high-dose aspirin, 80 to 100 mg per kg per day in four divided doses, until the patient is afebrile for 48 to 72 hours (some recommend continuing until the 14th day of illness has also passed). Afterward, low-dose aspirin at 3 to 5 mg per kg per day is given as a single dose until six to eight weeks after disease onset.
3.Approximately 10% of patients have refractory disease that does not respond to initial therapy (i.e., fever persists or recurs 36 hours after initial IVIG dose). These patients usually receive a second infusion of IVIG at 2 g per kg. The AHA guideline states that the relative roles of repeated use of IVIG and other adjunctive therapies (e.g., corticosteroids, TNF-ฮฑ antagonists, plasma exchange, cyclophosphamide).
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Behcets disease: recurrent oral ulcers, painful genital ulcers, and skin pustules after needle prick. Pathergy test is positive.
Clues to diagnosis:
โ Recurrent oral and genital ulcers
โ Pathergy test positive (papule/pustule after needle prick)
โ Skin pustules, erythema nodosum-like lesions
โ Systemic vasculitis that can affect eyes, CNS, joints, GI tract
๐ง Tip to remember:
"Behรงet = ulcers + pathergy + pustules"
Clues to diagnosis:
โ Recurrent oral and genital ulcers
โ Pathergy test positive (papule/pustule after needle prick)
โ Skin pustules, erythema nodosum-like lesions
โ Systemic vasculitis that can affect eyes, CNS, joints, GI tract
๐ง Tip to remember:
"Behรงet = ulcers + pathergy + pustules"
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juxtaphrenic peak sign, also known as diaphragmatic tenting or Kattan sign, refers to the peaked or tented appearance of a hemidiaphragm, which can occur in the setting of ipsilateral lung volume loss, e.g. lobar collapse, post lobectomy. It is caused by the retraction of the diaphragm at an inferior accessory fissure (most common 1), major fissure, or inferior pulmonary ligament. It is commonly seen in left or right upper lobe volume loss but may also be seen in middle lobe collapse
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CRP vs. Procalcitonin.
An evidence-based comparison between CRP and Procalcitonin (PCT), highlighting key evidence and guidelines regarding PCT's utility:
An evidence-based comparison between CRP and Procalcitonin (PCT), highlighting key evidence and guidelines regarding PCT's utility:
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