Objective To explore the diagnosis and treatment of Kawasaki disease(KD),the causes of misdiagnosis and prevention measures.Methods The clinical data of 35 children with KD treated from March 2014 to March 2023 were retrospectively analyzed.Results All 32 patients with complete KD had persistent fever,and the most prominent changes were oral changes,enlargement of cervical lymph nodes and ocular changes.Leukocyte count increased in 12 cases,platelets increased(＞450×109/L)in 27 cases at 7 d after fever and C-reactive protein(CRP)increased in 24 cases.Cardiac ultra-sonography showed coronary artery dilatation in 8 cases.There were 24 cases of initial misdiagnosis,including 18 cases of re-spiratory system infection,5 cases of diarrhea,and 1 case of neck lymphadenitis,and the corresponding treatment was not ef-fective.Three patients with incomplete KD had fever for more than 5 days,including 2 cases with oral changes,2 cases with cervical lymph node changes and 2 cases with eye changes.Leukocyte count,platelets and CRP were all elevated,and plate-lets increased(＞450×109/L)in 2 cases at 7 d after fever.Cardiac ultrasonography showed coronary artery dilation in 2 ca-ses.In the early stage,all patients were misdiagnosed,including 1 case of respiratory system infection,1 case of digestive system infection and 1 case of neck lymphadenitis,and the anti-infection treatment was not effective.The duration of misdiag-nosis of 27 cases was6-19(7.6±2.8)d.All 35 cases were diagnosed according to KD diagnostic criteria,34 cases were treated with human immunoglobulin and aspirin enteric-coated tablets,all of whom were cured clinically.One patient declined to use human immune gamma globulin and was discharged after fever.Conclusion Children with a long period of fever should be alert to KD in clinical practice,and doctors should inquire about the medical history in detail,analyze the clinical manifestations carefully,and combine the relevant medical examination for diagnosis,so as to ensure early diagnosis and time-ly treatment.
维普
万方数据