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Incomplete Kawasaki Disease — RACP Paediatrics MCQ

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HardInfectious DiseaseIncomplete Kawasaki DiseaseRACP Paediatrics

A 2-year-old presents with high fever for 5 days and a unilateral enlarged tender cervical lymph node (4 cm). Examination also reveals a unilateral non-purulent conjunctival injection and cracked, erythematous lips. There is no rash or limb swelling. He has only 3 of the 5 principal features of Kawasaki disease. CRP is 80 mg/L and ESR 65 mm/hr. What is the appropriate approach?

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Correct answer: C — The child has incomplete Kawasaki disease and should have an echocardiogram

Incomplete (atypical) Kawasaki disease should be considered in any child with unexplained fever ≥5 days with 2–3 principal features, particularly if inflammatory markers are elevated. Echocardiography should be performed as coronary artery abnormalities may be present. If supplementary laboratory criteria are met (or echo abnormalities found), treatment with IVIg and aspirin is indicated.

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