Kawasaki disease, also referred to as “mucocutaneous lymph node symdrome”, which was first

described in Japan by Dr. Tomisaku Kawasaki in 1967 and is now the leading cause of acquired
heart disease in children. It is defined as an acute febrile syndrome associated with generalized
vasculitis (inflammation of blood vessels) affecting all blood vessels throughout the body, including
the coronary arteries. The vasculitis is a principal and life-threatening symptom because it can lead to
the formation of coronary aneurysms which will predispose the child to thrombus formation and a high
risk of myocardial infarction.

II. Risk Factors

A. Age
B. Sex
C. Ethnicity

About 76% of Kawasaki disease cases occur in children younger than the age of 5 years, with males
affected more than females; it is also known to be more common among those of Asian and Pacific
Island descent.

III. Etiology

The etiology of Kawasaki disease remains unconfirmed. Although Kawasaki disease is not spread by
person-to-person contact, several factors support an infectious cause or trigger. It is often seen in
geographic and seasonal outbreaks, with most cases reported in the late winter and early spring.

In the continental United States, population-based and hospitalization studies estimate an incidence of KD ranging from about 9 to 20
per 100,000 children under 5 years of age.

The incidence of Kawasaki disease is much higher in Northeast Asian countries including Japan, South Korea, China, and Taiwan, 10–
30 times higher than that of KD in North America and Europe.

V. Clinical Manifestations

Signs and symptoms of Kawasaki disease include a high, persistent fever generally greater than
38°C, and often as high as 40°C. This “fever that doesn’t go away” lasts at least 5 days up to 2
weeks, and it does not subside well or for long with antipyretics. It does not usually go away with
normal doses of acetaminophen (Tylenol) or ibuprofen (Advil). The fever is considered a classic sign.

The signs and symptoms can be best remembered by using the acronym CRASH and Burn.
C – Conjunctivitis (inflammation of the conjunctiva): the white part of the eyes can get really red but
with no drainage or exudates
R – Rashes
A – Adenopathy (lymphadenopathy): meaning swollen or enlarged lymph nodes
S – Strawberry tongue: their tongues will resemble the fruit: red, swollen, with little indentations that
look like a strawberry. However, it can also cause dry, red, swollen, cracked red lips.
H – Hands and feet: the hands and feet will swell
Burn - This describes the fever that is typical of all Kawasaki disease. The fevers are typically high,
38-40C and last for at least five to seven days or longer.

Often other signs and symptoms are categorized by the three phases of the disease: