Question
A five-year-old girl presents with fever and conjunctivitis. Physical examination is significant for oral erythema and fissuring along with a generalized maculopapular rash and cervical lymphadenopathy. What is the most likely diagnosis?
| A. |
Henoch-Schonlein purpura
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| B. |
Polyarteritis nodosa
|
| C. |
Kawasaki disease
|
| D. |
Takayasu’s arteritis
|
Show Answer
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Correct Answer � C
Explanation
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|
Ans. C
Kawasaki disease Clinical diagnosis requires
Fever for at least 5 days and: ≥ 4 other specific symptoms, or < 4 specific symptoms if the coronary arteries are involved
Specific symptoms
Erythema and edema of hands and feet, including the palms and soles (the first week)
Desquamation of fingertips and toes (after 2–3 weeks)
Polymorphous rash, originating on the trunk
Painless bilateral “injected” conjunctivitis without exudates
Oropharyngeal mucositis
Erythema and swelling of the tongue (strawberry tongue)
Cracked and red lips
Cervical lymphadenopathy (mostly unilateral)
Nonspecific symptoms may precede the onset of Kawasaki disease (e.g., diarrhea, fatigue, abdominal pain)
Henoch-Schonlein purpura presents with abdominal pain, rashes, palpable purpura, and arthritis.
Polyarteritis nodosa and Takayasu’s arteritis have distinct presentations and are unlikely at this age.
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