AKT-1235

AKT-1235

You see a 3-year-old boy who has presented with a high fever.

He was first seen almost two weeks ago by a colleague and diagnosed with a viral upper respiratory tract infection and given simple advice. His parents have brought him back today as his fever doesn’t seem to be settling and they have noticed that his eyes have become irritated and his lips are very red and have cracked.

On examination, the child has a temperature of 38.1°C and has dry fissured lips. There is an obvious widespread polymorphous skin rash present. Examination of the mouth reveals pharyngeal injection and a prominent red tongue. Significant cervical lymphadenopathy and conjunctival inflammation is noted. There is palmar erythema bilaterally and his hands and feet appear puffy with peeling of the skin of the fingers and toes.

Which of the following is a complication of this condition?