Mucocutaneous lymph node syndrome. A case masquerading as Rocky Mountain spotted fever

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Abstract
Mucocutaneous lymph node syndrome is a recently described entity whose principal signs and symptoms include fever; unresponsiveness to antibiotics; congested conjunctivae; reddening of the oral cavity, lips, palms and soles; exanthem; edema; nonsuppurative cervical adenitis; and desquamation of the fingertips. Almost 7000 cases were reported in Japan. Analysis of the 39 cases reported in the USA reveals findings similar to those in Japan, except for a higher boy-to-girl ratio (2:1) and age distribution peaks at a later time (3 yr of age). A case in a 7 yr old girl with many characteristics of Rocky Mountain spotted fever, including a positive Well-Felix reaction, is reported. Some cases of mucocutaneous lymph node syndrome may be misdiagnosed as Rocky Mountain spotted fever.