1. Childhood Illnesses Slideshow Pictures
2. Parenting and Healthy Eating Slideshow Pictures
3. Parenting - Fitness and Exercise Slideshow Pictures

Medical Author:

David Perlstein, MD, MBA, FAAP

David Perlstein, MD, MBA, FAAP

Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.

View Full Profile

Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

View Full Profile

Kawasaki disease is an acute vasculitis that affects otherwise healthy children. The diagnosis of the disease is based on criteria as follows:

Fever of at least five days duration, exclusion of other causes of fever, and at least four of the following five clinical features

1. Bilateral nonpurulent conjunctival injection (red eyes)

2. Changes in the lips and oral cavity (red and cracked lips, strawberry tongue)

3. Rash (nonpetechial, nonbullous, nonvesicular)

4. Changes in the extremities (edema of the hands or feet, red hands or feet, peeling of the palms or soles)

5. Cervical lymphadenopathy (large lymph nodes of the neck, often unilateral)

6. Or fewer of these findings with evidence of coronary aneurysms or coronary enlargement seen on echocardiogram

Typically, a child with Kawasaki disease will have a with sudden onset of fever that has no apparent source. The fever lasts longer than five days, and the child is irritable and generally ill appearing. In addition to the fever, the above symptoms may develop in any order and duration. The diagnosis is made when the above criteria are met and there is no other explanation for the symptoms such as strep throat or an acute drug reaction.

Kawasaki disease can be divided into phases, including the acute, early phase (fever and other symptoms) that lasts from five to 10 days and is followed by the subacute phase (development of coronary artery aneurysms) from 11-30 days, and finally the convalescent phase (resolution of acute symptoms) from four to six weeks. For untreated patients, 25% develop coronary artery aneurysms that often will result in an acute heart attack (myocardial infarction) from months to years after the diagnosis.

The clinical features of Kawasaki disease can be mistaken for other illnesses such as streptococcal or staphylococcal infections (scarlet fever, toxic shock syndrome), viral infections (measles, adenovirus), and drug reactions (Stevens-Johnson syndrome).

In addition, some patients, especially younger or older patients, may develop incomplete Kawasaki disease or atypical Kawasaki disease in which the child may not have all four clinical features. Diagnosis in these situations is much more difficult.

Must Read Articles Related to Kawasaki Disease

Coronary Heart Disease Coronary heart disease (CHD), also called coronary artery disease, affects about 14 million men and women in the United States. Disease develops when a combinat...learn more >>

Edema Edema, or the abnormal accumulation of fluid in tissues in the body can be caused by several factors. Treatment of edema depends on the cause of the edema.learn more >>

Electrocardiogram (ECG) The electrocardiogram (ECG or EKG) is a diagnostic tool that measures and records the electrical activity of the heart in exquisite detail.learn more >>

See the Entire Kawasaki Disease Topic Guide »