Rapid Review: Kawasaki Disease
- Patient will be a child < 4 years old
- With a history of high fever for 5 days
- Complaining of conjunctivitis, rash, adenopathy, strawberry tongue, hand/feet edema, fever
- Treatment is IVIG + aspirin
- Comments: #1 cause of pediatric acquired heart disease, risk for coronary artery aneurysm
- Mnemonic: CRASH and burn: Conjunctivitis, Rash, Adenopathy, Strawberry tongue, Hand/feet edema, Fever
A 4-year-old girl is brought to the clinic because of fever. Five days ago, she had a fever with a maximum temperature of 39oC that was minimally responsive to antipyretics. This was accompanied by clear rhinorrhea. Last night, the parents noted a rash on her chest and back. The girl also has decreased activity and appetite. On physical examination, her temperature is 38.6oC, heart rate is 108 beats per minute, respiratory rate is 22 cycles per minute, bilateral bulbar conjunctival injection, cracked red lips, non-hyperemic posterior pharyngeal wall, morbilliform rash over the trunk, palpable right anterior cervical lymph node measuring 2 cm, clear breath sounds, no murmur, and soft abdomen. A complete blood count shows anemia and leukocytosis with left shift. Urinalysis shows pyuria. Which of the following is the most likely diagnosis?