| Diagnostic Criteria |
- Fever ≥5 days (required criterion)
- Bilateral non-exudative conjunctival injection
- Polymorphous (non-vesicular) rash
- Oral changes: strawberry tongue, red cracked lips, diffuse erythema
- Extremity changes: erythema/edema of palms/soles → periungual desquamation
- Single cervical lymph node >1.5 cm (not bilateral)
- Incomplete Kawasaki: fever + <4 criteria but elevated CRP/ESR + echo changes
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| Echo Urgency |
- Echocardiogram within 24 hours of diagnosis
- Coronary artery aneurysm (Z-score >2.5) = feared complication
- Risk of MI from coronary thrombosis
- Baseline echo + follow-up at 2 weeks + 6-8 weeks
- Echo is the FIRST next step when Kawasaki is suspected
|
| Treatment |
- IVIG 2g/kg single infusion (within 10 days of fever onset)
- High-dose aspirin 80-100 mg/kg/day (anti-inflammatory phase)
- Low-dose aspirin 3-5 mg/kg/day (antiplatelet) once afebrile
- Infliximab or repeat IVIG if refractory
- Avoid live vaccines for 11 months post-IVIG
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| Mimics |
- Viral exanthem (RSV, adenovirus): exudative conjunctivitis, no lymphadenopathy
- Scarlet fever: sandpaper rash, positive strep throat, responds to antibiotics
- Toxic shock syndrome: hypotension, shock
- Stevens-Johnson syndrome: mucosal involvement + bullae
- Measles: Koplik spots, prodrome of cough/coryza/conjunctivitis
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