Which of the following is NOT a recognized diagnostic feature of Kawasaki disease?

AIIMS Bhuvneshwar NO- 2018

Child Health Nursing (Pediatrics)

Easy

Appeared in: AIIMS Bhuvneshwar NO- 2018

Explanation

The defining ocular sign in Kawasaki disease is bilateral, non-purulent (non-exudative) conjunctivitis.
Purulent conjunctivitis involves a pus-like discharge, which is characteristic of bacterial infections and is specifically a feature that helps to rule out Kawasaki disease.
Textbooks explicitly state that exudative or purulent conjunctivitis is a clinical feature inconsistent with a diagnosis of Kawasaki disease.

Option B: This is a principal diagnostic criterion for Kawasaki disease. The conjunctivitis is characteristically bilateral and non-purulent (without pus).
Option C: This is one of the five principal diagnostic criteria for Kawasaki disease. It is typically a unilateral, non-tender cervical lymph node larger than 1.5 cm.
Option D: This is the core, mandatory criterion for diagnosing classic Kawasaki disease. The illness is defined by a persistent fever lasting at least 5 days.

Visual 1: Image - A close-up of a child's eye showing bilateral, non-purulent conjunctival injection (redness without pus) to illustrate the key ocular sign in Kawasaki disease.
Visual 2: Image - A picture of a 'strawberry tongue' in a child, showing the characteristic red, bumpy appearance.
Visual 3: Image - A photo of a child's hands showing erythema and edema, and another showing periungual desquamation (skin peeling around the nails).
Visual 4: Infographic - A chart summarizing the 'CRASH & Burn' mnemonic for the diagnostic criteria of Kawasaki disease.

Clinical Relevance

Nursing practice connection: Knowing Diagnostic criteria of Kawasaki disease helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Early and accurate diagnosis of Kawasaki disease is critical for nurses to facilitate timely treatment with Intravenous Immunoglobulin (IVIG) and aspirin.
The primary goal of treatment is to prevent the most serious complication: coronary artery aneurysms, which can lead to long-term cardiac problems, including myocardial infarction.
Nurses play a key role in monitoring for the full constellation of symptoms, as incomplete or atypical presentations are common, especially in infants.

How to Approach the Question

First, identify the core subject of the question, which is 'Kawasaki disease' and its 'diagnostic features'.
Note the negative keyword 'NOT'. This means you are looking for the option that is inconsistent with the diagnosis.
Recall the standard diagnostic criteria for Kawasaki disease, often remembered by the mnemonic 'CRASH and Burn'.
Evaluate each option against these criteria:
Option D (Fever > 5 days): This is the 'Burn' part, a core feature.
Option C (Cervical lymphadenopathy): This is the 'A' (Adenopathy) part, a key feature.

Concept Tested & Keywords

Concept Tested: Diagnostic criteria of Kawasaki disease
Stem keywords: Kawasaki disease, diagnostic feature
Lead-in keywords: NOT
Negative lead-in flag: The question asks to identify the feature that is NOT part of the diagnostic criteria for Kawasaki disease.

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