10 year female child had a focal seizure, CT showed CORTICAL parietaL granuloma. Started on Tegretol and AKT in v/o suspected Kochs as HS megaly was also there. SHRZ was started. Pt was having off and on fever since onset of symptoms, at times 102F; started on Ceftriaxone alongwith. Dengue titre was sent on day 5, IgM neg, IgG positive. Widal on same day was O=0, H=160, P Vivax Positive, Chloroquine course completed. On day 7, pt had erythematous rash allover body, the pictures are shown alongwith.

 

click below for the images of the rash..

counts 70000, E=20%,Platelets 60000, no significant imrovement with Hydrocort/atarax etc.
No joint pains/LM/Vmtg with minimal puffiness (angioedema like) of body but no pitting edema. Child was having hypotension, required dopamine drip.

Day 9, conscious since begining. BP under control. Temp off and on. Same rash.. turning brown..? no palpable purpura.

 Coated tongue, large tonsils, B/l cervical bullneck like LN pathy.Body is tender at most places.. HS megaly 7 cm each, firm.. false feel of tender HSM. repeat dengue IgG neg. Lepto Neg. any guesses whats going on?

can it be kawasaki disease?