Table 3.
Duration of fever | In the presence of ≥ 4 principal clinical features, particularly when redness and swelling of the hands and feet are present, KD can be diagnosed even with 4 d of fever |
History | Presence of one or more principal clinical manifestations of disease that can be revealed on history but have disappeared by the time of presentation, have been considered important for diagnosis |
KD shock syndrome | KDSS has been given special consideration in the 2017 revised guidelines because in the presence of shock the diagnosis of KD is often not considered |
KD in infants | Clinicians should have a lower threshold for diagnosis of KD in this age group |
Incomplete KD | Algorithm for incomplete KD has been simplified |
KD and infections | The issue of infections and KD has been detailed at length. Diagnosis of KD must not be excluded even in the presence of a documented infection when typical clinical features of KD are present |
Bacterial lymphadenitis | Ultrasonography and computed tomography findings in differentiating the 2 conditions- bacterial lymphadenitis is often single and has a hypoechoic core on ultrasonography, while lymphadenopathy in KD is usually multiple and is associated with retropharyngeal edema or phlegmon |
2D-echocardigraphy | The limitations of echocardiography and other diagnostic modalities have been highlighted. Z-score (by Manlihot et al) for severity classification of coronary artery abnormalities has been adapted |
KD: Kawasaki disease; KDSS: Kawasaki disease shock syndrome.