BMJ  2003;327:916 (18 October), doi:10.1136/bmj.327.7420.916

Clinical review

Interactive case report

A 2 year old child with rash and fever

¹ Department of Primary Health Care, Institute of Health Sciences, Oxford OX3 7LF, ² Royal Berkshire Hospital, Reading RG1 5AN

Four weeks ago (BMJ 20 September, p 668) we published the case of Elisabeth. Seventeen days after developing a fever and rash the skin fell off her fingers and toes and she was seen by a paediatrician. The paediatrician thought she might have Kawasaki disease. He discussed the case with a paediatric cardiologist and, because she had been ill for 17 days, decided not to give her intravenous immunoglobulins. Two days later she was seen by the paediatric cardiologist. Her echocardiogram was normal. The merits of giving low dose aspirin were discussed with Elisabeth's parents. Given her father's history of anaphylaxis, she was given a test dose. There were no adverse effects, and she was discharged home taking 50 mg of aspirin daily. At her three month follow up her echocardiogram was normal and the aspirin discontinued. There have been no long term sequelae, and Elisabeth remains well.

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Competing interests: None declared.

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