2. Classic clinical criteria:
• Fever persisting at least 5 days
• Presence of at least 4 principal features:
- Changes in extremities
Acute: Erythema of palms,soles;edema of hands,
feet
Subacute: Periungal peeling of fingers,toes in
weeks 2 and 3
- Polymorphous exanthem
- Bilateral bulbar conjunctival injection w/o
exudate
3. - Changes in lips and oral cavity: erythema,
lips cracking, strawberry tongue, diffuse
injection of oral and pharyngeal mucosae
- Cervical lympadenopathy ( >1.5- cm
diameter), usually unilateral
4. Other clinical and laboratory findings
• Cardiovascular findings
- Congestive heart failure, myocarditis, pericarditis,
valvular regurgitation
- Coronary artery abnormalities
- Aneurysms of medium-sized noncoronary arteries
- Raynaud’s phenomenon
- Peripheral gangrene
• Muskuloskeletal system
- Arthritis, arthralgia
5. • Gastrointestinal tract
- Hepatic dysfunction
- Hydrops of gallbladder
• Central Nervous System
- Extreme irritability
- Aseptic meningitis
- Sensorineural hearing loss
• Genitourinary system
- Urethritis/ meatitis
6. • Other findings
- Erythema, induration at BCG inoculation site
- Anterior uveitis ( mild)
- Desquamating rash in groin
7. Laboratory findings in acute Kawasaki
disease
• Leukocytosis w/ neutrophilia and immature forms
• Elevated ESR
• Elevated C- reactive protein
• Anemia
• Abnormal plasma lipids
• Hypoalbuminemia
• Thrombocytosis after 1 week
• Sterile pyuria
• Elevated serum transaminase
• Elevated serum gamma glutamyl transpeptidase
• Pleocytosis of CSF
• Leukocytosis in synovial fluid
8. Treatment of Kawasaki Disease
• Acute Stage
- IV Ig 2 g/kg over 10-12 hr w/ aspirin 80-100
mg/kg/24 hr divided every 6 hr orally until 14th
illness
day
• Convalescent Stage
- Aspirin 3-5 mg/kg OD orally 6-8 wk after illness
onset
9. • Long- Term Therapy for those w/ coronary
abnormalities
- Aspirin 3-5 mg/kg OD PO+/- dipyridamole 4-6
mg/kg/24 hrs in two or three doses orally (some add
warfarin for those patients high risk of thrombosis)
• Acute Coronary Thrombosis
- Prompt fibrinolytic therapy w/ tPA, streptokinase, or
urokinase under supervision of a pediatric
cardiologist
