Diagnosis and characteristics of typical and incomplete kawasaki disease

Abstract

Kawasaki disease (KD) is diagnosed on the basis of six characteristic symptoms, and several reference findings are used to confirm the diagnosis. Most patients are younger than 5 years. Fever is the first sign of KD in most patients, and although Japanese guidelines give equal weight to fever and the other five symptoms, the American Heart Association guidelines regard fever as indispensable to a KD diagnosis. The other principal signs are bilateral bulbar conjunctival injection, changes in the lips and oral cavity, polymorphous exanthema, changes in the extremities (including membranous desquamation from the fingertips), and cervical lymphadenopathy, which is less frequent than the other five symptoms. If KD is suspected in a patient with four or fewer principal symptoms, incomplete KD is diagnosed. Careful differential diagnosis is necessary in such cases because patients with incomplete KD can develop coronary artery aneurysms.