At the Kawasaki Disease Clinic at Rady Children’s Hospital-San Diego, led by Drs. Burns, caring for children with Kawasaki disease is always about finding the cause.
On a recent Wednesday morning, Dr. Kirsten Dummer, a pediatric cardiologist, was reviewing the heart scans of a 2-year-old boy who showed signs of a large aneurysm on the right side of the heart.
“The biggest question from parents is: How did this happen? How did my child get this? In every patient room, that’s basically what they want to know,” he said. Year after year, they come back and ask us, “Do you know more?”
Dr. Burns, who continued to see patients herself, said these investigations motivated her.
“If we were all PhDs in the lab working on the etiology of Kawasaki disease,” there would be a different pace to it, Dr. Burns said. “But there’s an urgency, because we’re going back and forth, from the lab to the patients, saying, ‘Damn, I’ve got to answer this question.’ It matters, because it matters to these people.”
Later that morning, Inez Maldonado Diega, a 4-year-old in a mermaid costume, was rolling out Play-Doh balls with her mother as Dr. Burns made the news. Seventeen days ago, the girl’s pediatrician’s office had lost a case of Kawasaki disease. An echocardiogram had come back clear – a sign that her heart was so healthy – but she still had a fever, which meant the disease could remain.
“I wish we had seen her sooner,” said Dr. Burns, listening to Inez’s heartbeat. She requested genetic samples for her biobank from both Inez and her mother, explaining that children are believed to inherit susceptibility to the disease from their parents.
Inez’s mother, Tiara Diega, assured Dr. Burns that she never had Kawasaki disease as a child — just scarlet fever. Dr. Burns raised her eyebrows and asked Ms. Diega to call her mother on speakerphone.
Did Ms. Diega have bloodshot eyes during the infection all those years ago, asked Ms. Diega’s mother? Yes, said the mother. Dr. Burns exhaled slowly.
“That wasn’t scarlet fever,” he said.
For a moment, the room was quiet — Mrs. Diega still held a Play-Doh burger in the air — as the dangers to both mother and daughter sank in. Dr Burns then referred Ms Diega for a heart scan – to see if there had been any serious risk over the years.
The sound is produced by Tally Abecassis.
