| CRITERIA American heart Association criteria for diagnosing KD is given below FEVER persisting for at least 5 days PRINCIPAL CLINICAL FINDINGS 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 |
GUIDELINES
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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 |
ABSTRACT |
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15% to 25% of untreated children and may lead to ischemic heart disease or sudden death. 
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-
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.