WBR0010

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Author PageAuthor::
Exam Type ExamType::
Main Category MainCategory::Neurology
Sub Category SubCategory::Pharmacology
Prompt [[Prompt::A 13-year-old boy is brought to the clinic for a fever of 5 days duration accompanied by a diffuse rash. His mother states that the fever has been as high as 103.0°F (39.4°C) and she has kept him out of school because of this. His physical exam is notable for a diffuse morbilliform rash over his trunk and extremities, which also becomes confluent in the groin. Both scleras are infected and his tongue is red and bumpy on appearance. Notable lymphadenopathy is present in the anterior and posterior cervical chains. What is the next step in management?]]
Answer A AnswerA::High-dose aspirin.
Answer A Explanation AnswerAExp::
Answer B AnswerB::High-dose tylenol.
Answer B Explanation AnswerBExp::
Answer C AnswerC::Obtain CBC and bone marrow biopsy.
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Answer D AnswerD::Admit to the hospital and start IV steroids.
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Answer E AnswerE::Start a course of amoxicillin and arrange follow-up in 2 days.
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Right Answer RightAnswer::A
Explanation [[Explanation::The patient described has Kawasaki's syndrome (KS) by the characteristic time course of fever, presence of rash, and marked cervical lymphadenopathy. Treatment of KS consists of high-dose aspirin with possible addition of IVIG as well as admission to the hospital for diagnostic workup including electrocardiogram/echocardiogram and management of any complications.

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