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Kawasaki Disease — RACP Paediatrics MCQ

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EasyCardiologyKawasaki DiseaseRACP Paediatrics

A 4-year-old boy presents with 6 days of fever, bilateral non-purulent conjunctival injection, cracked lips, a polymorphous rash, and swollen hands and feet. CRP is 120 mg/L and platelet count is 550 × 10⁹/L. According to the RCH Melbourne guidelines, what is the most important initial treatment?

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Correct answer: C — Intravenous immunoglobulin (IVIg) 2 g/kg as a single infusion plus aspirin

Kawasaki disease meeting diagnostic criteria should be treated with IVIg 2 g/kg as a single infusion over 10–12 hours, ideally within the first 10 days of illness, combined with aspirin. This reduces the risk of coronary artery aneurysms from approximately 25% to <5%. The dose of aspirin (high vs low) varies between guidelines; the RCH uses low-dose aspirin (3–5 mg/kg/day).

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Kawasaki Disease