Kawasaki disease (KD) is characterized by multisystem involvement and inflammation of small- to medium-sized arteries with resulting aneurysm formation. KD is the second most common vasculitis of childhood. KD most commonly occurs in children younger than 5 years of age, with a peak between 2 and 3 years.
A seasonal variability has been described with a peak between February and May, but the disease occurs throughout the year.
The clinical course of KD can be divided into three phases, each with its own unique manifestations.
The acute phase of KD, which lasts 1-2 weeks, is marked by sudden onset of a high, hectic fever without an apparent source.
- The onset of fever is followed by conjunctival erythema. Conjunctivitis is bilateral, bulbar, and nonsuppurative.
- Mucosal changes, including dry, cracked lips and a strawberry tongue
- Swelling of the hands and feet
- Cervical lymphadenopathy is found in 70% of children
- A morbilliform rash, which can vary in appearance, occurs in 80% of children
- Extreme irritability is prominent, especially in infants
- Abdominal pain and hydrops of the gallbladder
- Arthritis, particularly of medium-sized to large joints
- Carditis in the acute phase may be manifested by tachycardia, shortness of breath, or overt heart failure. Giant coronary artery aneurysms
- The subacute phase, which lasts until about the 4th week, is characterized by gradual resolution of fever and other symptoms.
- Desquamation of the skin, particularly of the fingers and toes, appears at this point.
- The platelet count, previously normal or slightly depressed
- This phase heralds the onset of coronary artery aneurysms
- Elevation erythrocyte sedimentation rate (ESR)
The convalescent phase begins with the disappearance of clinical symptoms and continues until the ESR returns to normal, usually 6-8 weeks after the onset of illness.
Beau lines of the fingernails may appear during this phase.
- Blood CBC,ESR,CRP,LFT,KFT
- URINE CULTURES
- CHEST X-RAY