Sujet de la discussion : MedeSpace.Net :: United State Médical Licensing Examination

Publié par La Pharmacienne le 15-02-2009 03:27
#42

The answer is d, Pharyngeal culture aids in the diagnosis of one of the conditions.

The two conditions in consideration are Kawasaki disease and scarlet fever (i.e., "strep" throat). Kawasaki disease is an acute febrile illness of unknown etiology and shares many of its clinical manifestations with scarlet fever. Scarlatiniform rash, desquamation, erythema of the mucous membranes that produces an injected pharynx and strawberry tongue, and cervical lymphadenopathy are prominent findings in both.

The most serious complication of Kawasaki disease and scarlet fever is cardiac involvement. Erythrogenic toxin-producing group A ß-hemolytic streptococcus is the agent responsible for scarlet fever. Isolation of the organism from the nasopharynx and a rise in antistreptolysin titers will confirm the diagnosis. Serologic tests for a variety of infectious agents, both viral and bacterial, have been negative in Kawasaki disease.

Rheumatic heart disease is a serious sequela of streptococcal pharyngitis, which can be prevented by appropriate treatment with penicillin. Coronary artery aneurysm and thrombosis are the most serious complications of Kawasaki disease. The current approach to treatment of Kawasaki disease, which includes specific therapy with aspirin and IV gamma globulin administered within a week of the onset of fever, appears to lower the prevalence of coronary artery dilatation and aneurysm and to shorten the acute phase of the illness.


Rq:

Neither has cardiac complications = Aucune des maladies n'a de complications cardiaques.
Rheumatic heart disease (or Rheumatic Fever) = Rhumatisme Articulaire Aigu