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Kawasaki Disease, Emergency Medicine

Reviewed 06/2017



  • Acute inflammatory process involving multiple organs

  • Leading cause of childhood-acquired heart disease in developed countries

  • Vasculitis is most severe in medium-sized arteries

  • Acute ca...


  • Classic diagnostic criteria:

    • Fever for 5 days + 4 of the 5 following criteria:

      • Bilateral conjunctival injection

      • Changes in oral mucosa

      • Polymorphous erythematous rash

      • Changes in hands or feet—edem...



  • ABCs

  • Oxygen

Initial Stabilization/Therapy

ABCs with focus on cardiovascular system 

Ed Treatment/Procedures

  • Initiate IV gammaglobulin (IVIG) and aspirin therapy:

    • Do not generally need ...



Admission Criteria

  • Admit all patients who fulfill diagnostic criteria for Kawasaki disease

  • Admit toxic-appearing patients who do not yet meet the criteria for Kawasaki disease

Discharge Criteria

Pearls and Pitfalls

  • Prompt diagnosis and therapy can prevent coronary aneurysms in 95%

  • Aspirin and IVIG are mainstays of therapy

  • Must consider the diagnosis in febrile children presenting to the ED for ...

Additional Reading

  • Ashouri  N, Takahashi  M, Dorey  F, et al. Risk factors for nonresponse to therapy in Kawasaki disease. J Pediatr.  2008;153:365–368.

  • Gerding  R. Kawasaki disease: A review. J P...



  • 429.0 Myocarditis, unspecified

  • 446.1 Acute febrile mucocutaneous lymph node syndrome [MCLS]

  • 447.6 Arteritis, unspecified

  • 420.90 Acute pericarditis, unspecified


  • I51.4 Myocarditis, unspecifie...

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