Recognizing Kawasaki disease

Kawasaki disease (KD) occurs most often in children from one to three years of age. It is a common systemic vasculitis that is rare in children older than eight years of age or younger than six months of age; however, it may occur in these age groups. Boys are affected more often than girls by a ratio of 1.5 to 1. The mean annual incidence rate reported in a recent Canadian study was 13/100,000 children younger than five years of age. The highest incidence rates occur in Japan. The purpose of the present paper is to help the clinician to recognize KD in children. In particular, the paediatrician must be aware of situations in which KD poses a diagnostic challenge, such as KD in an infant younger than six months of age and the child who presents with a prolonged, unexplained fever but insufficient criteria to make a diagnosis of KD.