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)
  • 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.