Specific criteria to diagnose Kawasaki disease

Kawasaki disease is a severe, uncommon childhood illness that causes inflammation of the blood vessels. Although there is no specific lab test to diagnose Kawasaki disease, criteria developed by the American Heart Association (AHA) are used to identify the condition.¹

Major symptoms of Kawasaki disease include:

• Red, bloodshot eyes, usually without pus or discharge.
• A red body rash that varies in size, shape, and consistency. The rash rarely blisters and is usually most obvious in the torso or groin area.
• Red, swollen, cracked lips and a red ("strawberry") tongue and lining of the mouth.
• Firm, swollen hands and feet with red palms and soles. The skin begins to shed and peel between 1 to 3 weeks after the fever starts. Peeling starts beneath the fingernails and toenails and slowly spreads to the palms and soles.
• Swelling of lymph nodes on one side of the neck.

Kawasaki disease is diagnosed if your child:

• Has a fever that has lasted at least 5 days
• Has 4 of the 5 major symptoms

Sometimes a child will meet some but not all of these criteria. This is called incomplete or atypical Kawasaki disease. It tends to occur in infants less than 1 year old. If your child has incomplete Kawasaki disease, your doctor will order blood tests to look for further signs of Kawasaki disease. Your child may also have a heart test called an echocardiogram to look for coronary artery damage. The results of these tests will determine what type of treatment your child will need.

Citations

1. Newburger JW, et al. (2004). Diagnosis, treatment, and long-term management of Kawasaki disease: A statement for health professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Pediatrics, 114(6): 1708–1733. [Erratum in Pediatrics, 115(4): 1118.]