Ranjith Karthekeyan Karthekeyan

A 2-year-old boy presented to the paediatric emergency department with a 5-day history of persistent high fever reaching 40°C, marked irritability, reduced oral intake, and non-productive cough. The child's mother reported onset of symptoms following a minor upper respiratory infection two weeks earlier, initially managed at home with oral paracetamol and later with oral antibiotics (amoxicillin) prescribed by a primary care physician, which failed to resolve the fever or other emerging symptoms. On examination, the child exhibited bilateral non-exudative conjunctival injection, strawberry tongue with red cracked lips, anterior cervical lymphadenopathy (right sided, 2 cm node), polymorphous erythematous rash across the trunk and extremities sparing the diaper area, and indurative oedema of the hands and feet. These findings fulfilled the diagnostic criteria for complete Kawasaki disease (KD), prompting immediate hospital admission for further evaluation and treatment.