CRASH AND BURN
expression/kraʃ ən ˈbɜːn/
Paediatrics
Definition
1.The diagnostic features of Kawasaki disease.
Expansion
- CConjunctivitis — bilateral, non-exudative, with limbal sparing
- RRash — polymorphous, trunk and perineum
- AAdenopathy — cervical, often unilateral, ≥1.5 cm
- SStrawberry tongue — with cracked, red lips (mucositis)
- HHands and feet — erythema and oedema, later desquamation
- BURNFever — ≥5 days, high and unremitting — the hallmark
Notes
Kawasaki disease is a medium-vessel vasculitis of young children. The diagnosis requires fever for ≥5 days plus four of the five CRASH features.
It matters because of the feared complication — coronary artery aneurysms. Treat promptly with IVIG and aspirin and arrange echocardiography. (Note: aspirin here is one of the few paediatric indications, given the small risk of Reye syndrome.)
Origin
The patient who will 'crash and burn' without treatment — a fever that ends in coronary aneurysms.