kawasaki%20disease
KAWASAKI DISEASE
Kawasaki disease is an acute, febrile illness that is self-limited. It is a systemic vasculitic syndrome that primarily involves the medium- and small-sized muscular arteries of the body.
It is also known as mucocutaneous lymph node syndrome.
It affects primarily children <5 years old with peak incidence in 1-2 year of age.
The cause remains unknown but current research supports an infectious origin.
Epidemiological findings suggest that genetic predisposition and environmental factors play a role in the pathogenesis of the disease.

Introduction

  • It is also known as mucocutaneous lymph node syndrome
  • Affects primarily children <5 years old w/ peak incidence in 1-2 years of age

Definition

  • Acute, self-limited, systemic vasculitic syndrome that primarily involves the medium- & small-sized muscular arteries of the body

Etiology

  • The cause remains unknown but current research supports an infectious origin
  • Epidemiological findings suggest that genetic predisposition & environmental factors play a role in the pathogenesis of the disease

Signs and Symptoms

Principal Clinical Criteria

  • Fever persisting ≥5 days (inclusive of those cases in whom the fever has subsided before the 5th day in response to therapy) plus
  • Presence of at least 4 out of the following clinical features:
    • Bilateral bulbar conjunctival injection w/o exudate
    • Polymorphous skin rash
    • Changes in lips (eg reddened, dry or cracked) & oral cavity (eg strawberry tongue, diffuse oral & pharyngeal hyperemia)
    • Changes in the extremities & in the perineum (eg erythema of palms or soles, indurative edema of hands or feet, desquamation of perineal skin)
    • Acute cervical lymphadenopathy (≥1 lymph node, unilateral, >15 mm in diameter)
  • Exclusion of other diseases w/ similar findings

Other Significant Symptoms

  • Should be considered in the clinical evaluation of suspected patients
  • Cardiovascular: hyperdynamic precordium, tachycardia, innocent flow murmur, gallop rhythm, distant heart sounds, angina pectoris
  • Gastrointestinal: diarrhea, vomiting, abdominal pain, paralytic ileus, acute acalculous distention of the gallbladder (hydrops), hepatic enlargement, mild jaundice
  • Skin: small pustules, erythema & induration at the site of a previous vaccination w/ Bacillus Calmette–Guérin (BCG), transverse groove on the nail plate
  • Respiratory: cough, rhinorrhea
  • Central nervous system: extreme irritability, aseptic meningitis, transient unilateral peripheral facial nerve palsy, transient high-frequency sensorineural hearing loss, convulsion, unconsciousness, paralysis of the extremities
  • Musculoskeletal: arthritis or arthralgia
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