2nd Annual Scientific Meeting: Hong Kong College of Paediatricans

摘要

Our story started with a 6-year-old girl, lived in Guangzhou, enjoyed good past health, presented with fever and very minimal cough and running nose. She was seen by doctor in China and was treated as upper respiratory tract infection with amoxil and common cold medicine. The cough and running nose did go away while fever persisted, she was brought to a Chinese herbalist subsequently and some herbs were given. Few days later apart from fever, she developed generalised non-itchy skin rash. Her parents hence brought her to Hong Kong for second opinion. At this juncture, she had been running a fever on and off with no particular pattern and obvious foci of infection for 2 weeks. On examination she was generally unwell with faint generalised blanchable erythematous skin rash not of sand-paper like. She had no meningeal sign. No lymphadenopathy or hepatosplenomegaly was noted. She had no sign of strawberry tongue, conjunctivitis and extremity changes suggestive of Kawasaki disease. Systemic examination was essentially normal. Initial investigations showed mildly elevated neutrophil count at 9.8x10⁹/L, with normal platelet count and haemoglobin. Inflammatory markers were moderately elevated with ESR at 46 mm/hr and CRP at 63.1 mg/L. Renal function, liver function, bone profile and urate were normal while LDH was slightly elevated at 720 IU/L. Nasopharygeal aspirate (NPA) and throat swab were negative. Urinalysis and CXR were normal.