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Kawasaki Disease — RACP Paediatrics MCQ

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HardCardiologyKawasaki DiseaseRACP Paediatrics

A 4-year-old child with Kawasaki disease received IVIg and aspirin but remains febrile 36 hours after completion of the IVIg infusion. What is the recommended next step?

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Correct answer: D — Repeat IVIg 2 g/kg

IVIg resistance in Kawasaki disease is defined as persistent or recurrent fever ≥36 hours after completion of the initial IVIg infusion. The RCH Melbourne guidelines recommend a second dose of IVIg 2 g/kg as the first-line treatment for IVIg-resistant KD. Corticosteroids and infliximab are considered for refractory cases after a second IVIg dose.

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