Recognition of Kawasaki Disease

Kawasaki disease is one of the most common vasculidities of childhood. It is the leading cause of acquired heart disease in children in the US.1 Although its course is typically self-limited, it is important that the clinician have a high degree of suspicion for its presence in light of its potential cardiac complications. It should be included in the differential diagnosis for any child with prolonged fever that is unresponsive to antibiotics. Diagnosis is often difficult in that the symptoms tend to present at different times. Usually a detailed medical history and multiple examinations (on different days) are needed to establish the diagnosis. Here, we present the case of a boy in whom a delayed diagnosis of Kawasaki disease was made after he had made multiple visits to pediatricians and also to the Emergency Department. In addition, the diagnostic criteria, differential diagnosis, treatment, and possible complications of Kawasaki disease are reviewed here.