PaediatricsPending review

Kawasaki disease

A medium-vessel vasculitis of unknown trigger inflames arteries throughout the body, producing a constellation of mucocutaneous signs that spell CRASH-and-burn, and the reason it cannot be missed is that the same process can destroy the coronary arteries.

In a nutshell

An immune-mediated vasculitis of medium vessels causes a persistent high fever plus CRASH features (Conjunctivitis, Rash, Adenopathy, Strawberry tongue/mucosal change, Hand/foot changes). The coronary arteries are especially vulnerable, and untreated disease can cause aneurysm, thrombosis and infarction even in young children. IVIG within 10 days of onset sharply cuts this risk.

Classic presentation

A child under 5 with fever for 5 days or more, bilateral non-purulent conjunctivitis, polymorphous rash, cervical lymphadenopathy, strawberry tongue with cracked lips, and swollen, later peeling, hands and feet.

Key points

Persistent fever ≥5 days unresponsive to antipyretics, with no source found, is the anchor feature that should trigger consideration of Kawasaki disease.

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Educational content pending clinical review. Not medical advice.