Unpacking Kawasaki Disease: Diagnosis and Management with Expert Dr Linny Kimly Phuong

In this episode of The Good GP, Dr Tim Koh is joined by Dr Linny Kimly Phuong, a paediatric infectious diseases physician, researcher, and academic tutor, to discuss Kawasaki disease.

They began by explaining Kawasaki disease as an inflammatory vasculitis with potential long-term cardiac consequences. Dr Phuong notes that one child is diagnosed with Kawasaki disease every day. While the disease is more common in children under the age of five, it can present at any age and across all ethnic groups, with a higher incidence in children of Asian ethnicity.

They discussed the clinical picture of Kawasaki disease, commonly remembered by the mnemonic "CRASH and burn." This includes Conjunctivitis, Rash, Adenopathy, Strawberry tongue, and Hand/feet changes—all accompanying a prolonged fever. Dr Phuong emphasises the importance of recognising these symptoms even if they do not manifest simultaneously.

They move onto diagnosis, highlighting the absence of diagnostic tests and the reliance on clinical evaluation supported by laboratory tests such as full blood count, inflammatory markers, and liver function tests. Dr Phuong also elaborates on differential diagnoses, including both infectious (e.g., scarlet fever, adenovirus) and non-infectious conditions (e.g., drug hypersensitivity, systemic juvenile idiopathic arthritis).

Finally, outlining the long-term clinical impact of Kawasaki disease, emphasising the importance of treatment with intravenous immunoglobulin and low-dose aspirin to reduce the risk of coronary artery aneurysms. Highlighting the necessity for long-term cardiology follow-up due to the potential for severe complications like coronary artery stenosis and myocardial infarction.

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