Misdiagnosis of older children suffering from Kawasaki disease in 1 case.doc

 PAGE \* MERGEFORMAT 5 Misdiagnosis of older children suffering from Kawasaki disease in 1 case [Keywords:] disease, older children, misdiagnosis A medical record Children, female, aged 14 and a half, weight 75 kg. Because of “Fever 14 days” on July 1, 2008 admission. 14 days ago and in children with fever and neck mass in the local hospitals for 5 days to be anti-inflammatory is still recurrent fever, June 22, 2008 in the District People’s Hospital diagnosed as acute upper respiratory tract infection to be Ceftezole, Yan Hu Ning home after anti-inflammatory treatment, the next day in the urban Third People’s Hospital due to “fever 6 days “Physical examination: T 40 ℃, eye conjunctiva, lips, mouth, tongue, mucous membrane hyperemia, hand, foot and palm rash, swollen extremities, check blood WBC 19.6 × 109 / L, N 0.521%, PLT 123 × 109 / L , chest radiograph showed right lower lung infection with “lower right pneumonia, mouth ulcers, rash of unknown origin” closing the hospital. hospitalization day symptom-free remission, in June 24, 2008 switch to City, a hospital, check blood WBC 13.9 × 109 / L, N 0.812, PLT 41 × 109 / L, diagnostic of allergic sub sepsis, the treatment of children a day of high fever, chills, nausea, vomiting, abdominal pain, diarrhea, dizziness, fatigue associated with chest tightness on June 25, 2008 0:00 into the Department of Respiratory Diseases, Union Hospital. auxiliary examination after admission: blood WBC 12.46 × 109 / L, L 0.794, PLT 27 × 109 / L, urine routine: WBC (+ +, Pro (+, ketones (+ +, bilirubin (+, occult blood (+++, stool: yellow thin, pus ball 5 ~ 6/HP, phagocytes 0 ~ 2/HP, Widal reaction (-, ASO 63 IU / mL, CRP 41.40 mg / L, ENA complete (-, EV-RNA (+, CMV-IgM (+, HCV-Ab (-, liver function TB 37.1 μmol / L, DB 21.4 μmol / L, ALT 301 U / L, AST 170 U / L, γ-GT 309 U / L, normal renal function and acid-fast bacilli sputum smear is not found, fungi, and Haemophilus, Shigella were not detected in stool and Salmonell