Overview

• Systemic, medium-sized vessel vasculitis. Predominantly seen in those <5 years old.
  • More common in asian children, particularly japanese and korean children.
  • Key complication is coronary artery aneurysm.

Making Diagnosis

Clinical Features

• Persistent high fever (>39ºC) for >5 days.
• Skin Findings → widespread erythematous maculopapular rash and desquamation (skin peeling) on palms and soles.
• Strawberry tongue (red tongue with large papillae).
• Cracked lips.
• Cervical lymphadenopathy.
• Bilateral conjunctivitis.

<aside> 💡 CRASH and Burn → Conjunctivitis, Rash, Adenopathy, Strawberry Tongue, Hand/feet redness and peeling. Burn = fever >5 days.

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Investigations

• FBC (anaemia, leukocytosis, thrombocytosis), LFTs (hypoalbuminaemia and raised liver enzymes), raised ESR.
• Urinalysis → raised WCC.
• Echochardiogram → coronary artery pathology.
  • Have at diagnosis, then again at 1-2 weeks and 6-8 weeks after treatment.

Management Plan