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Kawasaki Disease — EECC MCQ

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EasyGeneral CardiologyKawasaki DiseaseEECC

A 5-year-old boy presents with high fever for 7 days, bilateral non-exudative conjunctival injection, strawberry tongue, cervical lymphadenopathy, erythema and oedema of the hands and feet, and a polymorphous rash. Echocardiography shows a 6 mm coronary artery aneurysm of the left main coronary artery. What is the diagnosis and acute treatment?

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Correct answer: C — Kawasaki disease — high-dose intravenous immunoglobulin (IVIG) plus high-dose aspirin, with echocardiographic follow-up for coronary aneurysm progression

This is classic Kawasaki disease, an acute systemic vasculitis of childhood affecting medium-sized arteries (particularly the coronary arteries). Diagnosis requires fever ≥5 days plus ≥4 of 5 criteria: (1) bilateral conjunctival injection, (2) oral mucosal changes, (3) extremity changes, (4) polymorphous rash, (5) cervical lymphadenopathy. Coronary artery aneurysms develop in 25% of untreated cases. Treatment with IVIG (2 g/kg single dose) within 10 days of fever onset reduces coronary aneurysm rate to <5%. High-dose aspirin (30-50 mg/kg/day) is given during the acute phase, followed by low-dose aspirin (3-5 mg/kg/day) for 6-8 weeks. Giant aneurysms (>8 mm) require long-term anticoagulation and lifelong cardiac surveillance.

Reference: AHA Scientific Statement on Kawasaki Disease