Podcast: Play in new window | Download
A small vessel vasculitis that affects children, usually <5 years old.
Symptoms – remember the CRASH AND BURN mnemonic!
Rash – nonspecific morbilliform or maculopapular rash, usually on torso
Adenopathy – usually unilateral cervical lymphadenopathy
Strawberry Tongue – erythema, swelling, or cracking of lips/mucous membranes
Hands – swelling, erythema, or desquamation of the hands/feet
BURN – 5 days of fever
- COMPLETE KAWASAKI – 5 days of fever and 4/5 of the CRASH symptoms
- INCOMPLETE KAWASAKI – 5 days of fever and 2-3/5 of the CRASH symptoms, in the setting of elevated inflammatory markers (WBC, ESR, CRP)
Treatment: IVIG and High Dose Aspirin
Multisystem Inflammatory Syndrome in Children (MIS-C)
A new disease entity seen in children defined by widespread systemic inflammation affecting multiple organ systems that presents weeks after infection by COVID-19.
- Persistent Fever
- Skin involvement – nonspecific rash, conjunctivitis, changes to mucous membranes
- GI involvement – nonspecific abdominal pain, nausea, vomiting, diarrhea
- Renal involvement – acute kidney injury with elevated creatinine
- Cardiac involvement – elevated troponin/pro-BNP, reduced EF, cardiogenic shock
- Neuro involvement – altered mental status
Diagnosis and Treatment: Varies by hospital, but usually involves the presence of clinical symptoms along with a positive covid IgM/IgG, elevated inflammatory markers (WBC, ESR, CRP, Ferritin, DDimer), multisystem involvement (elevated troponin/proBNP, elevated creatinine, elevated LFTs, etc). These children need a stat ECHOcardiogram to rule out significant cardiac dysfunction.