On the fourth day of admission child became very sick, he was looking miserable, conjunctivae became red, developed measles like rash all over the body, lips cracked, tongue and buccal mucosa became intensively red and there was subcutaneous edema over palms and sole. Based on the foregoing clinical findings, he was diagnosed as Kawasaki disease; intravenous immunoglobulin was given along with oral aspirin- anti-inflammatory dose and supportive management maintaining the fluid and electrolyte balance. There was dramatic improvement clinically. Fever subsided within 24 hours of immunoglobulin infusion and urine output gradually improved and before discharge the renal parameters were returned to normal. He developed peeling of skin around the perianal area. An echocardiography done showed normal anatomy and function of the heart. Subsequently he was discharged on antiplatelet dose of aspirin and advised follow up. Echocardiography repeated two weeks after discharge showed right main coronary artery aneurysm of 5 mm in size. …show more content…
In both the published cases of KD and HUS, the HUS features were reported as complications of KD, while our case, the patient presented with clinical features of HUS hence making it the first reported case of such presentation. Luckily the patient showed typical features of KD on the 4th day of admission. On the contrary if the patient had not shown these features, there would have been delay in the diagnosis, with only on the features of HUS. Hemolytic uremic syndrome (HUS) is established as syndrome of heterogeneous group of correlative entities since 1955. In children it is considered as a predominant cause of community acquired acute renal failure. Statistics disclose that the probability of occurrence of HUS is one to three cases per 100,000 children per year16 .The three intrinsic features of HUS are microangiopathic hemolytic anemia, thrombocytopenia, and renal insufficiency
Pathophysiology When Pulmonary Stenosis is present, resistant to blood flow cause right ventricular hypertrophy – right atrial pressure will increase – reopening of the foramen ovale, shunting of unoxygenated blood into the left atrium, systemic circulation. Clinical manifestation: Cyanosis, characteristic murmur , cardiomegaly . Treatment: Baloon angioplasty (neonate).
Assessment 2 Short Essay Question -01 Discuss Mr. Ronald bates systemic assessment and priorities of management Mr. Ronald bates presented to the emergency department with shortness of breath (Respiratory rate- 24 breaths/min) and general discomfort (pain score- 4/10) and it was started in the morning and worsens when doing activities. The above presenting complaints lead to a possible cardiac event, so that this presentation would be triaged as category 2. Therefore, medical officer would be notified regrading patient presentation and put Mr. bates to semi fowler’s position in the Emergency bed if this position is comfortable for him. Further primary systemic assessment of the patient starts with an order with an assessment of
He is in no acute distress. Blood pressure 120/78. Pulse 70 and regular. Weight 177 pounds. Height 5 '6".
's health deteriorated as a direct result of the shot to his chest. He had emergency surgery which lead to a narrowing of the aortic valve opening, aortic stenosis. Thus causing D.R. to have poor circulation in his lower extremities and an increase of pressure that could only be relieved surgically. An infection developed in the bone after his second surgery.
They Measured the kids for several hours comparing them to charts. Eva also said she had to give blood supplements every other day (Schwan). The doctors had injected them three times a week. One time after an injection Eva hot terribly sick.
There was a high probability the bacterial infection could have been necrotizing fasciitis due to the overlapping signs and symptoms of both infections. Both of these bacterial infections can be caused by a Gram-positive bacteria called Clostridium perfringens and the portal of entry for this endospore is through breaks in the skin that will infect the tissue. Necrotizing fasciitis causes intense pain and swelling at the site of infection. Discoloration of the skin along with hot to the tough, fever, nausea, malaise and other flulike symptoms. Patients normally have extremely low blood pressure which results in confusion.
5. Approach to the diagnosis. 5.1. Is it cardiac or not? 5.2.
It is best for the kid to be brought to the medical professional to receive antibiotic and treatment with erythromycin. Additionally, the health care provider may suggest for members of the family to
He stays in the hospital over a liver condition that fails to be jaundice, but his fever
He was wandering in the desert for 2 months, and disoriented to time, although; he continued to call his daughter’s name, and asked for his wife. He had a number of bruises on his face, and his toes on his right foot were black, in fact the toes fell off. The doctor’s had to auto transplant his kidney, except his BP dropped and the man experienced cardiac arrest. Then they ordered an Echocardiogram, which this disturbed Dr. Pierce, for she suggested that it be done first.
The presentation that will be presented is about bacteria infecting young children especially in Nursery or Day-care facilities, named as Kingella kingae. This presentation is strongly related to the Diagnostic microbiology course, because it is widely spread among children with immature immunity and it can cause lots of diseases that still microbiologists are discovering in a daily basis. During the past ten years, Kingella kingae transmission has increased and led to many serious infections like: septic arthritis, bacteremia, osteomyelitis, and a lot more. Most of these cases were detected among children in Day-Care centers specifically in US and France, and at that period of time medical microbiologists did not focus on it yet.
Genetically, traditional hereditary hemophilia can be categorized as type A or B depending on whether the eighth (FVIII) or ninth (FIX) blood clotting factors are affected, respectively. These factors are enzymes and other proteins that form the clotting response when a cut occurs. The exact type can be diagnosed by either blood testing, or in the case of carrier, genetic testing. Though hemophilia has varying severity levels depending on the degree of damage to the protein 's amino acid sequence, it does not progress or change in severity over time. Patients considered to be moderate cases have only 1-5% of the average working blood clotting factor they are deficient in, and severe cases have as little as 0.5-1% - such cases are extremely hard to manage even with modern
Pathophysiology of Hematuria Throughout the process of filtration by the kidneys, along with the help of the ureters, the bladder and urethral to expel urine from the body, there are many possibilities that abnormalities can develop that could compromise the healthy characteristics of the filtration process. Hematuria, for example, is the irregular presence of red blood cells in the urine due to dissected variations of trauma in the urinary tract. There are two types of causes of hematuria, the glomerular and nonglomerular cause. The glomerular cause is trauma within the nephrons of the kidneys, where red blood cells enter the urine stream from the glomerulus.
Failure to thrive, vomiting, diarrhea and prolonged conjugated hyperbilirubinemia are the commonest presenting symptom. Jaundice and hepatomegaly develop early. Cataract also develops with time. Untreated disease may progress to cirrhosis. Ascites may develop with continued galactose ingestion as the disease progresses and is present in most infants who die due to this
Determinants of Pneumonia in children Indonesia study case Introduction Pneumonia commonly is caused by bacteria such as Streptococcus pneumoniae ,Haemophilus influenzae, Staphylococcus aureus, and some strains of respiratory virus like influenza, parainfluenza, and adenovirus (NCID, 2005). This disease in children is characterized by cough with difficult or rapid breathing and chest indrawing. (Wardlaw et al, 2006) Pneumonia contributes greatly for children death below 5 year in the world. Figure 1 describes that more than 10 million children in the world die before they reach their fifth birthday.