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第6階段 — 評估結果。審查臨床和心臟超音波趨勢，並選擇最佳的解釋和應對措施。

Trend

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Time	Data
Before IVIG	Temperature 39.1 C; irritable; LAD coronary Z-score 2.7體溫39.1°C；煩躁不安；左前降支冠狀動脈Z分數2.7
24 hours after IVIG	Temperature 37.2 C; drinking fluids; irritability improved體溫37.2°C；飲用液體；煩躁不安改善
40 hours after IVIG	Temperature 38.7 C returns; CRP remains elevated體溫38.7°C再次出現；C反應蛋白(CRP)仍升高
Follow-up echo	LAD coronary Z-score increases to 3.2左前降支冠狀動脈Z分數增加至3.2

Q1. Which interpretation is best supported?哪種解釋最能獲得支持？

The child has a complete response with no cardiac risk個案有完全反應且無心臟風險 The fever is an expected harmless IVIG reaction發燒是預期中無害的靜脈注射免疫球蛋白(IVIG)反應 The child may have IVIG-resistant disease with increasing coronary involvement個案可能患有靜脈注射免疫球蛋白(IVIG)抗性疾病，且冠狀動脈受累程度增加 The initial diagnosis is excluded初步診斷已排除

Q2. Which response is the priority?哪種應對措施是優先的？

Notify the pediatric cardiology team and prepare prescribed additional anti-inflammatory treatment通知小兒心臟科團隊，並準備處方額外的抗發炎治療 Discharge because the child was previously afebrile讓個案出院，因為個案之前已退燒 Stop all coronary imaging停止所有冠狀動脈影像檢查 Give an unsupervised over-the-counter antipyretic and reassess next week給予非處方退燒藥，不需監督，並於下週重新評估

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