AANP Family Nurse Practitioner (FNP) Certification ExamDiagnosisMedium
A 3-year-old child presents with a 2-day history of high fever (up to 103°F/39.4°C), bilateral non-purulent conjunctivitis, polymorphic rash on the trunk, and cervical lymphadenopathy. The child's lips are red and cracked, and the tongue has a 'strawberry' appearance. The mother denies any recent illnesses in other family members. What is the most likely diagnosis?
- AAdenovirus Infection
- BMeasles
- CKawasaki Disease
- DScarlet Fever
Show answer & explanationAnswer & explanation
Correct answer: C. Kawasaki Disease
The constellation of prolonged fever, bilateral non-purulent conjunctivitis, polymorphic rash, cervical lymphadenopathy, and characteristic oral mucosal changes (red/cracked lips, strawberry tongue) in a young child is classic for Kawasaki Disease, a systemic vasculitis.
Why the other options are wrong
- A. Adenovirus infection can cause fever and conjunctivitis, but typically does not present with the specific rash, oral changes, or significant cervical lymphadenopathy seen here.
- B. Measles (Rubeola) presents with a maculopapular rash, cough, coryza, conjunctivitis, and Koplik spots, but usually does not have cracked lips or cervical lymphadenopathy as prominent features.
- D. Scarlet fever typically presents with a 'sandpaper' rash, perioral pallor, and strawberry tongue, but lacks conjunctivitis or prominent lymphadenopathy beyond the neck.
Kawasaki Disease
An acute systemic vasculitis primarily affecting young children, characterized by fever and specific mucocutaneous findings, with a risk of coronary artery aneurysms.
- Leading cause of acquired heart disease in children in developed countries.
- Diagnosis based on fever for ≥5 days plus ≥4 of 5 principal clinical features.
- Treatment involves IV immunoglobulin and aspirin to prevent cardiac complications.
Memory trick: FEVER + CRASH: Conjunctivitis, Rash, Adenopathy, Strawberry tongue, Hand/foot changes.