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. 2022 Apr 1;12(4):884. doi: 10.3390/diagnostics12040884

Table 1.

Comparative view of the diagnostic criteria of Kawasaki disease, incomplete or atypical Kawasaki disease, and pediatric multisystemic inflammatory syndrome, with permission from Voicu et al. [9,10,11]. COVID-19: coronavirus 2019 disease; LAD: left anterior descending; NTproBNP: N-terminal pro Brain type natriuretic peptide; RCA: right coronary artery; RT PCR: reverse transcriptase-polymerase chain reaction; WBC: white blood cells.

Kawasaki Disease (KD) Incomplete (or Atypical) KD Pediatric Multisystemic Inflammatory Syndrome (Required all 6 Criteria)
Fever, and 4/5 criteria:
  • -

    Erythema and cracked lips, strawberry tongue, and/or erythema of the pharynx and oral mucosa

  • -

    Bilateral bulbar conjunctival injection

  • -

    Rash maculopapular, erythematous

  • -

    Erythema and edema of the hands and feet in the acute phase or periungual desquamation in the subacute phase

  • -

    Cervical lymph nodes ≥ 1.5 cm.
  • -

    Children with:

  • ·

    Prolonged Fever (≥ 5 days)

  • ·

    2–3 criteria

OR
  • -

    Infants with Prolonged Fever (≥7 days without other explanation)

  • -
    Compatible laboratory tests (3 of the 6 criteria)
    • o
      anemia
    • o
      thrombocytosis after the 7th day of fever
    • o
      albumin level ≤3 g/dL
    • o
      elevated ALT level
    • o
      WBC ≥ 15,000/mm3
    • o
      urine ≥ 10 WBC/hpf
  • -
    Compatible echocardiographic findings (any of the following)
    • o
      Z score LAD or RCA ≥2.5
    • o
      Coronary artery aneurysm
    • o
      ≥3 features from:
  • -

    Decreased LV function

  • -

    Pericardial effusion

  • -

    Z score LAD 2–2.5

  • -

    Mitral regurgitation
  • -

    Child 0–19 years

  • -

    Fever ≥ 3 days

  • -
    Clinical signs of multisystem involvement (at least 2 of the following):
    • o
      rash/bilateral non-purulent conjunctivitis/mucocutaneous inflammation signs: oral, hands, or feet
    • o
      hypotension or shock
    • o
      features of myocardial dysfunction, pericarditis, valvulitis, coronary abnormalities (echo findings or troponin/NT proBNP)
    • o
      evidence of coagulopathy (prolonged prothrombin time, partial thromboplastin time, or elevated D-dimers)
    • o
      acute gastrointestinal symptoms (diarrhea, vomiting, abdominal pain)
  • -

    Elevated markers of inflammation such as C reactive protein, procalcitonin, erythrocyte sedimentation rate.

  • -

    No other obvious microbial cause of inflammation, including bacterial sepsis, staphylococcal/streptococcal toxic shock syndrome

  • -

    Evidence of COVID-19 (RT PCR, antigen test, serology) or likely contact with patients with COVID-19