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SSSS — RACP Paediatrics MCQ

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HardNeonatalSSSSRACP Paediatrics

A 3-year-old has six days of fever, bilateral non-purulent conjunctivitis, oral erythema, cervical lymphadenopathy and extremity swelling. CRP is high, but the first echocardiogram shows normal coronary dimensions. What is the best treatment decision?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Start intravenous immunoglobulin infusion together with ongoing low-dose aspirin

Explanation lettering: C = shown as A · E = shown as B · B = shown as C · A = shown as E

D is correct. This clinical Kawasaki disease presentation requires IVIg 2 g/kg plus low-dose aspirin; an early normal echocardiogram neither excludes the diagnosis nor justifies delaying treatment. A loses the opportunity to reduce coronary risk. B aspirin alone is insufficient primary therapy. C desquamation is late and antibiotics do not treat vasculitis. E treatment remains indicated during this active inflammatory phase.

Reference: RCH Melbourne, Kawasaki disease: https://www.rch.org.au/clinicalguide/guideline_index/Kawasaki_disease/