A 10-year-old Asian patient presents with an erythematous maculopapular rash, conjunctivitis, a mild fever of 102.1 and a strawberry tongue. The rash started 4 days ago. How are you going to evaluate this patient? What is the differential diagnosis for this patient? Describe your treatment plan based on current guidelines.
Length: A minimum of 275 words, not including references
Citations: At least 2 high-level scholarly reference in APA 7 from within the last 5 years.
The assessment would entail history taking regarding the onset and progression of symptoms, the patient’s and the mother’s health history, and presence of other associated symptoms. It would also entail a careful examination of the patient’s signs and symptoms to observe for patterns. The evaluation would also entail laboratory tests to assess for infection and rule out diseases with similar symptoms. The laboratory tests would include blood tests to evaluate for anemia and inflammation are signs of Kawasaki disease. It would also entail a urine test to assess for white blood cells in the urine, which may indicate infection. An electrocardiogram would help detect heart problems and an Echocardiogram would evaluate for the integrity of coronary arteries, which may reveal Kawasaki disease (Singh, Jindal & Pilania, 2018).
The most probable diagnosis is Kawasaki disease. The disease can be viral or bacterial (Pilania et al., 2019). The patient presents with symptoms of this disease. The differential diagnosis include erythematous maculopapular rash, fever, conjunctivitis and a strawberry tongue. Besides, the condition is most common in children. The other differential diagnosis is scarlet fever. The patient presents with some symptoms of this bacterial infection. These are erythematous maculopapular rash, mild fever, and a strawberry tongue. Besides, the disease is common in children aged 5 to 15 years. The other differential diagnosis is Measles. The patient presents with some symptoms of this viral infection. These include conjunctivitis, rash, fever, and strawberry tongue.
The recommended first-line treatment for Kawasaki disease includes intravenous Gamma globulin (2 g per kg of body weight in a single infusion), an immune protein to lower the risk of a blood clot and inflammation of blood vessels. The drug should be combined with a high dose of Aspirin (80g) to treat inflammation, pain, and fever (Pilania et al., 2019). Because children should be given Aspirin only under the supervision of a doctor, the current patient should be treated as an inpatient (Jia et al., 2020). In addition, due to the potentially severe complications of Kawasaki disease, such as heart damage, the patient should be closely monitored for at least 3 days. Follow-up tests should be after every six weeks to check for the child’s heart health.