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Kawasaki disease — MCCQE Part 1 MCQ

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HardChild with FeverKawasaki diseaseMCCQE Part 1

3-year-old child presents with fever for 6 days. He has bilateral conjunctivitis, cracked lips, cervical node, rash and swollen hands. Which of the following is the most appropriate next step?

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Correct answer: A — Give IVIG and acetylsalicylic acid with echocardiography/cardiology involvement

Give IVIG and acetylsalicylic acid with echocardiography/cardiology involvement is best because prolonged fever with mucocutaneous features suggests Kawasaki disease. Provide only reassurance without clear follow-up or safety-netting is suboptimal because children can deteriorate quickly and follow-up must be explicit; Use adult dosing or adult pathways without paediatric adjustment is suboptimal because children require age- and weight-appropriate care; Delay assessment until the next routine visit is suboptimal because developmental, infectious and neonatal red flags require timely assessment; Give antibiotics, steroids or investigations routinely despite no indication is suboptimal because over-treatment can cause harm when supportive or targeted care is indicated. Treatment within 10 days reduces coronary aneurysm risk.

Reference: Canadian Paediatric Society Kawasaki disease statement