小儿烧伤后川崎病的诊治

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We try to discuss the relationship between burn and Kawasaki disease (KD), and to study the diagnosis and treatment of KD in burn children. The medical records of one burn child with KD from our pediatric ward together with those of 5 burn children with KD retrieved from foreign literature were analyzed. The clinical features of KD, including bilateral nonexudative conjunctivitis, erythema of the lips and oral mucosa, skin rash, cervical lymphadenopathy, changes in the distal part of extremities, were enrolled in the study. Six patients were male and younger than 5 years old, with 2 suffering from mild burn, 2 with moderate burn, and 2 with severe burn. Two days after second degree burn, all burn children had fever and skin rash with 4 or 5 clinical symptoms and signs of KD. Among them, coronary artery dilatation was found in 1 case as detected by echocardiography, positive wound culture was found in 2 cases, negative blood culture was found in 6 cases. All patients were given high-dose gamma globulin or (and) aspirin within 10 days after the first fever, followed by control and amelioration of the disease. We conclude that the pathogenesis of KD may be related with burn wound and reabsorption of edema. KD may be suspected in burn children younger than 5 years when they had fever and skin rash at the same time.
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