Pediatric Cardiology and Congenital Cardiovascular Disease

Biography

Biography: Sadaf Chaudhry

Abstract

Sepsis in infants is a well-recognized entity with clear-cut treatment. However, what if the presenting infant does not respond to antibiotics and fluid treatment? What if the symptoms persist? When does one start thinking about alternative diagnoses? A pediatric team at a small DGH faced this problem. With this case report we would like to share our thought process and the challenges our team faced considering the atypical presentation of Kawasaki disease. Kawasaki disease is an acute febrile systemic vasculitis. Being the most common cause of acquired heart disease in the UK, early diagnosis and treatment is essential. Kawasaki disease remains a clinical diagnosis based on clinical criteria. Some patients do not fully meet these criteria, forming an incomplete form of the disease. This subtype still poses a significant risk of cardiac consequences; hence forming a challenging group of patients. In our case, a five month old boy initially seemed to present with septic shock. Despite appropriate antibiotic treatment his temperature did not settle. In addition the inflammatory markers only increased. He remained extremely irritable and had an extensive maculopapular rash. On day five of his illness, he was suspected to have incomplete Kawasaki disease. ECHO confirmed the presence of cardiac sequelae. This clinically septic child responded remarkably well to intravenous immunoglobulins and high dose aspirin.