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
'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.
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.
Localization of the pain was consistent from the T4 to T5dermatome (on the right anterior, lateral and posterior chest wall). He described the pain as severe stabbing and lancinating with a numeric rating scale (NRS) of 8/10. The patient also reported sleep disturbances due to the pain, which had begun 20 day earlier but had aggravated within the last 1 week. He had a 3-year history of taking anticoagulants for the management of arterial fibrillation. At our pain clinic we prescribed tramadol and low dose pregabalin, but they failed to provide pain relief.
This figure may still not reflect the actual burden of this disease, owing to lack of investigative modalities in this resource poor country. Diagnostic work up in a case of Type 3 vWD patient who presented with bleeding symptoms is presented below. CASE: 18 month old male child, a resident of rural India, born out of consanguineous marriage was
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.
If you have two hemoglobin abnormalities than you have hemoglobin ss. Hemoglobin ss is sickle cell anemia, it is the most common and basically the worst. Sickle cell anemia is a mutation. There is also a mutation gene that helps make hemoglobin and the red blood cells turn into a sickle shape.
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.
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.