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Kawasaki disease — MRCPCH FOP MCQ

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HardCardiologyKawasaki diseaseMRCPCH FOP

A 3-year-old boy has had fever for 6 days with bilateral conjunctival injection, cracked lips, a polymorphous rash and swollen hands. CRP is raised and urine dipstick shows sterile pyuria. What is the most likely cause?

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Correct answer: A — Systemic medium-vessel vasculitis with coronary artery risk

The prolonged fever with conjunctivitis, mucosal changes, rash, extremity swelling and sterile pyuria is Kawasaki disease, a systemic vasculitis with important coronary artery risk. Scarlet fever can cause fever, rash and tongue changes but conjunctivitis and swollen hands with sterile pyuria point away from it. IgA vasculitis causes palpable purpura, abdominal pain and renal findings rather than this mucocutaneous syndrome. The pearl is that treatment is time-sensitive because coronary complications are preventable.

Reference: NICE CKS Kawasaki disease; RCPCH guidance