diagnostic criteria of Kawasaki disease (KD)

 Q: The diagnostic criteria of Kawasaki disease (KD) requires fever for at least? (select one)

A) 3 days

B) 5 days

C) 7 days

D) 10 days

E) 2 weeks

Answer: B

Kawasaki disease is mostly presents in children but sometimes may occur in adults too (reference # 2). The most profound hallmark feature of KD is fever above 101.3ºF which remains unresponsive to antipyretics. For KD, fever should last more than 5 days. Besides, four out of the five criteria should be present. 

Criteria were presented more than five decades ago by Dr. Kawasaki T. as "Acute febrile mucocutaneous syndrome with lymphoid involvement with specific desquamation of the fingers and toes in children".  

1. Changes in extremities: Acute erythema and edema of hands and feet and in the convalescent period, membranous desquamation of fingertips.
2. Polymorphous exanthema.
3. Bilateral, painless bulbar conjunctival injection without exudate.
4. Changes in lips and oral cavity: Erythema and cracking of lips, strawberry tongue, diffuse injection of oral and pharyngeal mucosae.
5. Cervical lymphadenopathy (≥1.5 cm in diameter) is usually unilateral.

Cardiac involvement is not required to diagnose KD though it strongly supports the diagnosis.

#rheumatology

References:

1. Kawasaki T. [Acute febrile mucocutaneous syndrome with lymphoid involvement with specific desquamation of the fingers and toes in children]. Arerugi 1967; 16:178. 

2. Anne E. et. al. Acute Kawasaki Disease: Not Just for Kids J Gen Intern Med. 2007 May; 22(5): 681–684. doi: 10.1007/s11606-006-0100-5 PMCID: PMC1852903 PMID: 17443379 

3.  Burns JC, Glodé MP. Kawasaki syndrome. Lancet 2004; 364:533.