Kawasaki Disease (KD) is fairly common disease in children. It is a serious disease as it involves coronary arteries in almost 1/4th of the patients. Difficult to diagnose as there is no single confirmatory test. A very young infant with KD may present only with high fever & marked irritability with none of the clinical features described below. Once you suspect the diagnosis, investigate with lab tests and cardiac ECHO.
Important symptoms & signs of Kawasaki Disease :
Fever persisting for at least 5 days and presence of at least four of the five principal features :
- Changes in extremities
Acute: Erythema of palms, soles; edema of hands, feet
Subacute: Periungual peeling of fingers and toes in 2 to 3 weeks
- Bilateral bulbar conjunctival injection without exudate
- Cervical lymphadenopathy (>1.5 cm diameter), usually unilateral
- Changes in lips and oral cavity: erythema and cracking of lips, strawberry tongue and/or erythema of oral and pharyngeal mucosa
- Rash: maculopapular, diffuse erythroderma, or erythema multiforme-like.
The presence of exudative conjunctivitis, exudative pharyngitis, oral ulcerations, splenomegaly, and vesiculobullous or petechial rashes should prompt consideration of alternative diagnosis.