Kawasaki Disease or Incomplete Kawasaki Disease Clinical Pathway — Emergency Department and Inpatient

Inconsistent with KD: Illnesses and Characteristics with Features Similar to KD

The principal clinical findings in KD are not specific; therefore, other illnesses with similar features should be considered.

Characteristics Presence should prompt consideration of alternate diagnosis	Exudative conjunctivitis Exudative pharyngitis Discrete intraoral lesions Bullous or vesicular rash Generalized adenopathy Splenomegaly
Alternative Diagnoses (Could Co-exist with KD)	MIS-C Measles Other viral infections (e.g. adenovirus, enterovirus) Staphylococcal and streptococcal toxin-mediated diseases (e.g. scarlet fever and toxic shock syndrome) Drug hypersensitivity reactions, including Stevens Johnson syndrome Systemic onset juvenile idiopathic arthritis With epidemiologic risk factors: Rocky Mountain spotted fever or other rickettsial infections Leptospirosis
Lab Findings Inconsistent with KD	CRP < 3.0 mg/dL AND ESR < 40 mm/hr

American Heart Association. 2017 Mar: Circulation 135:00-00. Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association. McCrindle et al.

©2024 by Children's Hospital of Philadelphia, all rights reserved.
Use of this site is subject to the Terms of Use.

The clinical pathways are based upon publicly available medical evidence and/or a consensus of medical practitioners at The Children’s Hospital of Philadelphia (“CHOP”) and are current at the time of publication. These clinical pathways are intended to be a guide for practitioners and may need to be adapted for each specific patient based on the practitioner’s professional judgment, consideration of any unique circumstances, the needs of each patient and their family, and/or the availability of various resources at the health care institution where the patient is located.

Accordingly, these clinical pathways are not intended to constitute medical advice or treatment, or to create a doctor-patient relationship between/among The Children’s Hospital of Philadelphia (“CHOP”), its physicians and the individual patients in question. CHOP does not represent or warrant that the clinical pathways are in every respect accurate or complete, or that one or more of them apply to a particular patient or medical condition. CHOP is not responsible for any errors or omissions in the clinical pathways, or for any outcomes a patient might experience where a clinician consulted one or more such pathways in connection with providing care for that patient.