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Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.
user
A 5-year-old girl presents with a rash and a persistent fever of 41.0°C (105.8°F), not relieved by Tylenol. The patient’s mother says that her symptoms started 5 days ago and have not improved. The rash started on her trunk and now is present everywhere including the palms and soles. Her birth history is normal. Her pulse is 120/min and respiratory rate is 22/min. On physical examination, the patient is agitated and ill-appearing. There is significant swelling of the distal upper and lower extremities bilaterally. The pharynx is hyperemic (see image). Generalized edema with non-palpable cervical lymphadenopathy is noted. Muscle tone is normal. Remainder of exam is unremarkable. Laboratory findings are significant for the following:
Laboratory test
Hb 9 g/dL
RBC 3.3/mm3
Neutrophilic leukocytosis 28,000/mm3
Normal platelet count 200,000/mm3
Serum ɣ-GT increased
Hyperbilirubinemia 2.98 mg/dL
AST and ALT are normal, but there is markedly increased serum CRP. Which of the following is the most likely diagnosis in this patient?
assistant
Kawasaki disease