Kawasaki disease
An acute systemic medium-vessel vasculitis in childhood with persistent fever and mucocutaneous features; it is a time-critical diagnosis because coronary artery inflammation can lead to aneurysm, thrombosis and myocardial ischaemia.
Definition
Kawasaki disease is an acute systemic medium-vessel vasculitis of childhood, diagnosed clinically from prolonged fever and a changing combination of mucocutaneous features. Its importance is the risk of coronary artery abnormalities and thrombosis, which early specialist treatment reduces.
First principles
The fever is the trigger for consideration, not a diagnostic gate
Kawasaki disease is a clinical diagnosis in which a persistent fever is accompanied by a changing combination of mucocutaneous signs. NICE advises considering it in every child with fever lasting 5 days or longer and asking about features that may have already disappeared. Fewer features are common early in the illness and in infants, so the classic mnemonic is a memory aid rather than a rule that must be completed before referral or treatment.
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