About Kawasaki disease all are true EXCEPT:
Correct Answer: Suppurative lymphadenopathy
Description: ANSWER: (D) Suppurative lymphadenitisREF: Harrisons 17th ed chapter 319KAWASAKI DISEASE, also referred to as mucocutaneous lymph node syndrome, is an acute, febrile, multisystem disease of children. Some 80% of cases occur prior to the age of 5, with the peak incidence occurring at <2 years.It is characterized by:Nonsuppurative cervical adenitisChanges in the skin and mucous membranes such as edema; congested conjunctivae; erythema of the oral cavity, lips, and palmsDesquamation of the skin of the fingertips.Although the disease is generally benign and self-limited, it is associated with coronary artery aneurysms in 25% of cases, with an overall case-fatality rate of 0.5-2.8%. These complications usually occur between the third and fourth weeks of illness during the convalescent stage.Vasculitis of the coronary arteries is seen in almost all the fatal cases that have been autopsied.There is typical intimal proliferation and infiltration of the vessel wall with mononuclear cells. Beadlike aneurysms and thromboses may be seen along the artery. Other manifestations include pericarditis, myocarditis, myocardial ischemia and infarction, and cardiomegalyTreatment of choke:The prognosis of this disease for uneventful recovery is excellent.High-dose IV globulin (2 g/kg as a single infusion over 10 h) together with aspirin {100 mg/kg per day for 14 days followed by 3-5 mg/kg per day for several weeks) for coronary complications.
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