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?
A. Measles.
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.
Sources:
Question & Explanation: Peterson AR, Wood KE. Pediatrics Examination and Board Review. New York, NY: McGraw-Hill Education; 2017.
Photo: Prose NS, Kristal L. Weinberg's Color Atlas of Pediatric Dermatology, 5e; 2017.
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