So when their 7-month-old daughter, Brielle, developed a fever and rash in May 2010, the Brick couple didn't panic. Instead, they visited the pediatrician, gave Brielle an over-the-counter fever reducer, and kept a close eye on her.
But when the fever stretched to five days and the rash worsened, they started to worry. Another examination convinced the pediatrician that Brielle likely had something called Kawasaki disease. This autoimmune condition causes inflammation of the blood vessels and, in a small number of children, can lead to coronary aneurysm, a potentially fatal condition. The family was sent straight to K. Hovnanian Children's Hospital at Jersey Shore University Medical Center.
Experience, Access to Specialists Key
K. Hovnanian Children's Hospital offers more pediatric subspecialists than any children's hospital in the area. For Brielle, that meant prompt visits with a pediatric infectious disease specialist and with pediatric cardiologist Maria Angela Umali, M.D.
"They were so methodical and reassuring. I never really worried," Kerry says. "I knew she was in good hands."
Researchers still haven't established what causes Kawasaki, and it can't be confirmed with a blood test. Accurate diagnosis depends on experience and around-the-clock access to pediatric specialists.
"It's a team effort between the pediatrician, the infectious disease specialist, and the cardiologist," explains Dr. Umali. "Together, we evaluate symptoms, rule out other infections, and perform tests to support the diagnosis."
The Importance of a Prompt Diagnosis
Complications from Kawasaki disease are preventable, as long as it's caught early, Dr. Umali says. That's because the risk for coronary aneurysm jumps significantly if a child is not treated within the first 10 days.
The most common symptom of Kawasaki disease is a fever that lasts longer than five days. Other signs include a rash, cracked lips, conjunctivitis, swelling or peeling of the fingers or toes, and a swollen lymph node.
When Dr. Umali examined Brielle, she was six days into her fever. Dr. Umali performed an echocardiogram, a noninvasive ultrasound study, to examine the coronary arteries.
When the test showed coronary dilation and inflammation, Dr. Umali supported the diagnosis of Kawasaki disease and recommended immunoglobulin treatment. This antibody-rich medicine, made from pooled plasma, helps reduce fever and inflammation.
Brielle was back to normal almost as soon as she finished the daylong treatment. Dr. Umali says Brielle will recover fully and should live a completely normal life.
For the Fehers, the fast diagnosis and return to normal almost makes them wonder if the whole thing ever happened. "She's just so healthy now and doing all the things a baby should be doing," Adam says.
About the Doctor
Maria Angela T. Umali, M.D.
Pediatric Cardiology
Brick | 732-458-9666
