Collagen Vascular and Other Multisystem Disorders Case
A 5-year-old boy presents with 7 days of fever to 39.4°C (103°F) daily.
A 5-year-old boy presents with 7 days of fever to 39.4°C (103°F) daily. He is irritable and has a morbilliform rash, conjunctivitis, swelling of his feet, and large adenopathy of the neck. Laboratory tests show leukocytosis, anemia, elevated alanine aminotransferase (ALT), and pyuria.
What is the diagnosis?
B. Stevens-Johnson syndrome.
C. Kawasaki disease.
D. Scarlet fever.
E. Adenovirus infection.
The correct answer is “C.” Kawasaki disease is a vasculitis affecting children typically between 6 months and 6 years of age. Symptoms self-resolve after 2 weeks. However, without treatment up to 25% of patients will develop coronary artery aneurysms. Table 7–5 shows characteristic laboratory abnormalities. The differential diagnosis includes viral infections (adenovirus, measles), Stevens-Johnson syndrome, and scarlet fever.