Kawasaki disease (KD), or mucocutaneous lymph node syndrome, is a multisystem vasculitis that affects infants and children. The disease occurs primarily in children under the age of 6. It is classically characterized by fever lasting at least 5 days (usually longer) plus 4 of the 5 following criteria:
- Conjunctival injection without exudate
- Red lesions of the mouth or pharynx
- Acute hand and foot edema followed by peeling
- Polymorphous cutaneous eruption
- Lymphadenopathy (usually cervical)
Oral mucous membrane changes are present in roughly 90% of patients with KD. The most common findings are diffuse oral mucositis, erythematous tongue with prominent fungiform papillae ("strawberry tongue"), and cracked lips. Only one of these findings is necessary to fulfill the diagnostic criteria. Discrete oral lesions, such as vesicles or ulcers, and exudative inflammation are not consistent with KD.
Most individuals affected by KD follow a benign disease course. However, coronary artery aneurysms develop in 20%-25% of untreated patients. Treatment is aimed at decreasing the risk of developing coronary artery abnormalities and preventing complications from these abnormalities.
A
multisystem inflammatory syndrome potentially linked to
COVID-19 has been reported in children and young adults; clinical features include Kawasaki-like and
toxic shock syndrome-like presentations.
