Paediatricsmiddle twist
A 7-month-old girl has had fever above 39 °C for seven days despite paracetamol. She is irritable and difficult to console. Her eyes are red without discharge, her lips are cracked, and there is a blotchy red rash on the trunk with peeling of the skin around the nappy area. Her hands and feet appear puffy. There are no enlarged lymph nodes, no cough or runny nose, and no oral ulcers. Results: white cell count 17 × 10⁹/L, platelets 640 × 10⁹/L, C-reactive protein 110 mg/L, ESR 82 mm/h, ALT 88 U/L, sterile pyuria on urine microscopy. Blood cultures are negative at 48 hours.
Which one of the following is the most likely diagnosis?