Experienced and skilled Pediatricians in the country are diagnosing & treating difficult and rare childhood diseases; no need to go abroad for your c

Mahathir, a 3 yr 9 months old boy of Khulna, just came back from his first foreign trip with his parents, to Singapore. He is a lively happy boy and his parents dote on him. His mother Shahida Begum found him to be warm one morning, which to her fear by the end of the day went upto high fever of 104° F, with swelling of neck glands (more on left side) and also glands in the axilla and groin. Further, he developed few rashes on his body.

On advice from a local pediatrician, Mahathir was brought to the Out-patient Pediatric Department of a renowned hospital of Dhaka where he was primarily treated as a case of gland infection; antibiotics therapy and some investigations were advised. After four days, when he returned to the hospital for follow up Consultation with the test reports, he still was having high fever, and then looking at Mahathir, the Consultant Pediatrician of this Internationally Accredited hospital took a pause. His thoughts looking at the patient's presentation in his own words are, "It suddenly crossed my mind that Mahathir's features have similarity with a few patients of Kawasaki Disease I have seen before.” Mahathir was admitted to the hospital and was investigated thoroughly. As the Consultant presumed from the tell-tale signs, it was clinically established that he was suffering from Kawasaki Disease.

Kawasaki Disease is a very rare disease, causing inflammation of medium sized arteries affecting different organs- predominantly heart, skin, mucous membranes and lymph nodes. The disease affects young children below 5 years of age in 80% cases; most of them are between 6 months to 2 years of age. It occurs more in boys. The first phase, which can last for up to 2 weeks, usually involves a persistent fever higher than 104° Fahrenheit (39° Celsius) and lasts for at least 5 days.

Other symptoms that typically develop include:

• severely red but dry eyes
• different type of rashes on the trunk, limbs and genitals
• sore, red, dry, cracked lips
• swollen tongue with a white coating and big red bumps (strawberry tongue)
• sore mouth, irritated throat
• swollen palms of the hands and soles of the feet with a purple-red color, grooves in nails
• swollen lymph nodes

During the second phase, which usually begins within two weeks of when the fever started, skin peeling may begin in large pieces, around the nails and over fingers, palms, toes and soles the skin on the hands and feet. Most serious involvement is on the arteries of the heart leading to Myocardial Infarction and occasionally causing death. The child also may experience joint pain, diarrhea, vomiting, abdominal pain, extreme irritability or fast heart beat.

Fortunately, Mahathir did not develop heart complication and barely was at the right time to start specific treatment to avoid dreadful heart disease. He was given high intravenous doses of gamma globulin (purified antibodies) very slowly in drip, an ingredient of blood that helps the body fight infection Intravenous Immunoglobulin. He was also given a high dose of aspirin to reduce the risk of heart problems. With a big smile, Mahathir left for home with his parents after seven days stay in the hospital. On subsequent follow up, he was found quite healthy, jolly and his echocardiography report also showed normal heart structure and function.

Prompt diagnosis of such rare disease like Kawasaki Disease is essential, rapid onset of treatment are the main keys to save lives by protecting the child from fatal complications. Do not waste time by taking your child to inexperienced child specialists or to abroad.