Primary care leads to rare diagnosis at WMC

Tristan Hanson (7) of Decorah was diagnosed with Kawasaki disease by Scott Bohner, D.O., Mayo Clinic Health System family medicine physician at Winneshiek Medical Center. After aggressive treatment at Mayo Clinic, Tristan suffered no heart damage and is healthy again.

Kurt and Janice Hanson assumed their son’s illness was a virus. On the Sunday before Thanksgiving, seven year-old Tristan was throwing up, had a fever and was lethargic – symptoms of the many illnesses that run through the school-age population. But it was the presence of a rash on his mid-section that prompted Janice to call Winneshiek Medical Center Decorah Clinic to make an appointment. The next morning, Tristan was in the office with Scott Bohner, D.O., Mayo Clinic Health System primary care doctor at WMC.

“Dr. Bohner gave him an overall exam and tested for strep throat, but everything came back fine,” says Janice. The family continued over-the-counter medicine to relieve his fever, but with little success. “Dr. Bohner’s nurse, Alissa, called the next day to check on Tristan, but he was still the same. She said if Tristan still showed no improvement by Friday, Dr. Bohner would like him to come in for more testing,” says Janice.

Friday arrived with no improvements. But Dr. Bohner had been working in the background to arrive at a diagnosis, including contacting pediatric specialists at Mayo Clinic in Rochester. The final testing at Friday’s appointment pointed to what Dr. Bohner had suspected; Tristan had Kawasaki disease.

“Kawasaki disease is rare, and occurs in children,” says Dr. Bohner. “It causes inflammation of arteries throughout the body, but if treated within a window of 5-10 days, recovery is likely with no lasting damage to the heart.”   Fortunately, Winneshiek Medical Center’s connections to Mayo Clinic were for the benefit of Dr. Bohner’s patient – Tristan was seen in Rochester that afternoon and by Friday evening, was admitted to Mayo Eugenio Litta Children’s Hospital for IV treatment.

And all the while, Tristan maintained his spunky personality, even poking fun at the team of doctors providing his care at Mayo Children’s Hospital. “Tristan couldn’t understand why such a large team of people needed to check on him. He thought one would be enough, and he told them so!” says Janice.

Before he left Mayo Children’s Hospital, Tristan had an echocardiogram to check for any heart damage, which came back clear. He has had two more echocardiograms since, and still shows no signs of damage. “Tristan’s specialist at Mayo made the comment that the heroes of Tristan’s story were the little guy himself, and his local primary care doctor, who persisted to find a diagnosis,” says Janice.

“I feel lucky and fortunate to have such amazing care in Decorah and to experience the benefits of Winneshiek Medical Center’s connections to Mayo Clinic first-hand. There isn’t a specific test to diagnose Kawasaki disease; rather they had to eliminate other possibilities and truly understand his symptoms. Because of their combined expertise, Tristan is healthy again and ready for a great summer!” says Janice.

Why is regular primary care important?

Primary care, otherwise referred to as family medicine or family practice, provides whole-person care for you and your family, whether you are healthy, facing an illness or managing a chronic condition. By establishing a long-term relationship with your primary care provider, you can work together to prevent or treat illness and coordinate specialty care, if needed, while receiving the best value for your health care dollars. Teams of primary care physicians, physician assistants and advanced nurse practitioners see patients daily at Winneshiek Medical Center Decorah, Ossian and Mabel Clinics. Call 563-382-2911 to make an appointment.

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