In this section
Kawasaki disease is a systemic vasculitis that predominantly affects children
< 5 years of age.
Although the specific aetiological agent remains unknown, it is believed that Kawasaki disease is a response to some form of infection (though it is not transmitted from person to person).
Diagnosis is often delayed because the features are similar to those of many viral exanthems.
The diagnostic criteria for Kawasaki disease are:
Fever for 5 days or more, plus
4 out of 5 of:
and exclusion of diseases with a similar presentation: staphylococcal infection (e.g. scalded skin syndrome, toxic shock syndrome), streptococcal infection (e.g. scarlet fever, toxic shock-like syndrome not just isolation from throat), measles, other viral exanthems, Steven's Johnson syndrome,
drug reaction and juvenile rheumatoid arthritis.
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The diagnostic features of Kawasaki disease can occur sequentially and may not all be present at the same time. Moreover, it is recognised that some patients with Kawasaki disease do not develop sufficient features to fulfill the formal diagnostic criteria. In particular, infants
less than 12 months of age are both more likely to have incomplete criteria and more likely to develop coronary aneurysms. Therefore, clinical vigilance is necessary to recognise these incomplete cases. This is important because the atypical cases are probably at
similar risk of coronary complications and require treatment (
American Heart Association Algorithm Fr incomplete Kawasaki Disease.) Other relatively common features include arthritis, diarrhoea and vomiting, coryza and cough, uveitis, gall bladder hydrops. Some patients get myocarditis.
All patients should have
Other tests are not diagnostic or particularly useful. The following may be seen:
Thrombocytosis and desquamation appear in the second week of the illness or later. Their absence earlier does not preclude the diagnosis.
Patients require admission to hospital if Kawasaki Disease is diagnosed or strongly suspected.
Provide the Kawasaki Disease Parent Information Sheet.
Sheet (Print version - PDF)
Parent Information Sheet (HTML version)
Paediatric follow-up should be arranged on discharge. At least one further echocardiogram should be performed at 6-8 weeks. If this is normal, no further examinations are needed.