Kawasaki Disease

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.

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