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Guidelines of Kawasaki Disease
American heart Association criteria for diagnosing KD is given below  
FEVER    persisting for at least 5 days    
 1. Bilateral conjunctiva injection (no exudate)
    2. Acute cervical lymphadenopathy (unilateral/ bilateral /firm/ slightly tender with a diameter of 1.5cm)       
    3. Strawberry tongue, oropharyngeal erythema, redness and cracking of lips (ulcerative lesions not seen)       
    4. Polymorphic exanthema: - erythematous maculo papular rash, (sometimes morbilliform/scarlentiform)
       usually  appears within 5 days of fever, starting with red palms and soles and moving to the trunk
    5. Red, swollen, indurated hands and feet and later desquamation of hands and feet after 1-3 weeks    
Fever plus 4/5 Principal criteria or  Fever plus 3/5 + Coronary artery dilatation can be considered for the diagnosis of Typical KD and Fever + 3/5 Principal criteria is in favor for atypical KD, but both typical and atypical need treatment

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
Jane W. Newburger, MD, MPH, Masato Takahashi, MD, Michael A. Gerber, MD, Michael H. Gewitz, MD, Lloyd Y. Tani, MD, Jane C. Burns, MD, Stanford T. Shulman, MD, Ann F. Bolger, MD, Patricia Ferrieri, MD, Robert S. Baltimore, MD, Walter R. Wilson, MD, Larry M. Baddour, MD, Matthew E. Levison, MD, Thomas J. Pallasch, DDS, Donald A. Falace, DMD, Kathryn A. Taubert, PhD

Background. Kawasaki disease is an acute self-limited vasculitis of childhood that is characterized by fever, bilateral nonexudative conjunctivitis, erythema of the lips and oral mucosa, changes in the extremities, rash, and cervical lymphadenopathy. Coronary artery aneurysms or ectasia develop in ~15% to 25% of untreated children and may lead to ischemic heart disease or sudden death.

Methods and Results. A multidisciplinary committee of experts was convened to revise the American Heart Association recommendations for diagnosis, treatment, and long-term management of Kawasaki disease. The writing group proposes a new algorithm to aid clinicians in deciding which children with fever for ≥5 days and ≤4 classic criteria should undergo electrocardiography, receive intravenous gamma globulin (IVIG) treatment, or both for Kawasaki disease. The writing group reviews the available data regarding the initial treatment for children with acute Kawasaki disease, as well for those who have persistent or recrudescent fever despite initial therapy with IVIG, including IVIG retreatment and treatment with corticosteroids, tumor necrosis factor-{alpha} antagonists, and abciximab. Long-term management of patients with Kawasaki disease is tailored to the degree of coronary involvement; recommendations regarding antiplatelet and anticoagulant therapy, physical activity, follow-up assessment, and the appropriate diagnostic procedures to evaluate cardiac disease are classified according to risk strata.

Conclusions. Recommendations for the initial evaluation, treatment in the acute phase, and long-term management of patients with Kawasaki disease are intended to assist physicians in understanding the range of acceptable approaches for caring for patients with Kawasaki disease. The ultimate decisions for case management must be made by physicians in light of the particular conditions presented by individual patients.
Published online December 1, 2004
PEDIATRICS Vol. 114 No. 6 December 2004, pp. 1708-1733 (doi:10.1542/peds.2004-2182)

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