Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Kawasaki disease is an acute illness, associated with fevers, that mainly
affects previously healthy children between 6 months to 5 years of age.
Kawasaki disease is currently the most common cause of acquired heart disease in
children in the developed world. The diagnosis of Kawasaki disease is based on
fever of at least five days' duration and a number of additional signs and
symptoms, which often appear in sequences rather than all at once.
The diagnosis of Kawasaki disease is considered in any child with prolonged fever, regardless of other symptoms. Of note, Kawasaki disease is associated with a risk of developing critical widening of the arteries to the heart (coronary artery aneurysms) and subsequent heart attacks in untreated children.
Kawasaki disease was first reported in Japan in the 1960s, and the rates of
the disease remain highest in Japan, followed by Taiwan and then Korea, though
the rates in Europe and North America are increasing.
The first symptom usually is a sudden, high fever that may be 104 F or higher. Unlike fever caused by common viruses, the fever from Kawasaki disease can last more than 10 days if the disease is not treated.
Other symptoms that can occur along with fever include:
Red, bloodshot eyes, usually without pus or discharge.
A red body rash that varies in size, shape, and consistency. The rash rarely blisters and is usually most obvious in the torso or groin area.
Red, swollen, cracked lips and a red ("strawberry") tongue and lining of the mouth.
Firm, swollen hands and feet with shiny red palms and soles. The skin begins to shed and peel between 1 and 3 weeks after the fever starts. Peeling starts under the fingernails and toenails and slowly spreads to the palms and soles.
Swelling of lymph nodes on one side of the neck. Swelling very rarely occurs on both sides of the neck.