RT Book, Section A1 Cooley, Anthony A2 Tenenbein, Milton A2 Macias, Charles G. A2 Sharieff, Ghazala Q. A2 Yamamoto, Loren G. A2 Schafermeyer, Robert SR Print(0) ID 1155426984 T1 Kawasaki Disease T2 Strange and Schafermeyer's Pediatric Emergency Medicine, 5e YR 2019 FD 2019 PB McGraw-Hill Education PP New York, NY SN 9781259860751 LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1155426984 RD 2024/03/28 AB The principal pathologic feature of Kawasaki disease (KD) is an acute vasculitis that affects the microvessels (arterioles, venules, and capillaries) anywhere in the body.Since there are no pathognomonic laboratory findings, the diagnosis is established clinically by the presence of fever and at least four of five clinical features (conjunctival injection, oropharynx erythema, cervical adenopathy, hand and foot erythema/swelling, and rash).As many as 20% of children will have incomplete KD, with only two of the conventional diagnostic criteria. Elevated C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR) should raise suspicion in these children, and consultation with a local expert is advised.Positive screening tests for an infectious etiology of an acute illness may identify a concomitant infection, carrier state, or viral shedding and therefore may not exclude a diagnosis of KD.All patients diagnosed with KD should be hospitalized for administration of intravenous gamma globulin (IVIG), aspirin therapy, and cardiac evaluation.The overall mortality rate of KD in American children ranges from 0.1% to 0.2% and peaks between 15 to 45 days after the onset of fever. Patients receiving treatment within the first 8 to 10 days of the onset of fever have the best prognosis.