have however reduced the acute mortality rate from about 2% in the 1970s to less than 0.2%. This article reports on a recent cluster of KD patients seen at 2 hospitals in Cape Town. Each case highlights a particular learning point or challenge in the diagnosis or management. CASE 1 -SEVERE KDA 15-month-old previously well boy was admitted with diarrhoea and vomiting, cough and fever which had persisted for 4 days. On examination he was lethargic with a temperature of 38.6°C and an