Kawasaki Disease

Question 1

Diagnostic criteria

CRASH + burn

Answer 1

Fever at least 5 days & >4 of
- change in extremities - erythema, oedema, desquamation
- bilateral conjuctivitis
- Unilateral cervical lymphadenopathy
- strawberry tongue
- polymorphous rash

Question 2

Ix

Answer 2

FBC - thrombocytosis, neutrophilia
ESR, CRP - elevated
LFT - raised ALT, dec albumin
ASOT - strep A testing
Echo

Question 3

Complications

Answer 3

AMI
Heart failure
Myocarditis
Arrythmias
Pericardial effusion
Aseptic meningitis

Question 4

Mx

Answer 4

Aspirin 5mg/kg/day
IVIG 2g/kg over 10hrs
Prednisone - high risk pts (<2m.o, asian, echo w cardiac involvement, Albumin <30)
IV Hydration
Paracetamol

Question 5

DDx

Answer 5

Infection - Acute rheum fever, scarlet fever
TSS
Viral infxn - EBV,CMV, adenovirus
Non infectious - SJS, JIA
Drug rxn
Malignancy
Sepsis