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Kawasaki's disease

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Acute febrile disease occurring in children 2 months to 9 years, usually under the age of 5. Male to female ratio 1: 5. Fever lasts 1 to 2 weeks. Other characteristic features are a strawberry tongue, reddening of the oropharyngeal mucosa, conjunctivitis, a bright red erythema of the hands and feet, and a morbilliform maculopapular rash on the trunk and limbs within 5 days of the onset of the fever. Enlarged cervical lymph nodes occur in half to three quarters of the patients. Indurative oedema and pain in the extremities are sometimes the predominant physical features. In the acute phase the coronary arteries can become dilated; this can lead to the development of aneurysms of the coronary arteries, and to death.

Kawasaki first saw the illness in a 4 year old boy in 1961. "I could make no diagnosis of this unusual sickness for which I could find no reference in any medical literature." In 1967 he 1967 described 50 cases of infants with persistent fever, accompanied by rash, lymphadenopathy, oedema, conjunctival injection, redness and cracking of the lips, "strawberry tongue," and convalescent desquamation. The incidence is higher in Japan than in any other country. In the United States it is more frequent among children of Asian-American background, but can occur in any racial or ethnic group. It can occur in small epidemics. Higher incidence in summer. The cause is unknown.

We thank Tadaaki Hiruki and Leah Rodriguez for information submitted.


  • T. Kawasaki:
    Acute febrile mucocutaneous syndrome with lymphoid involvement with specific desquamation of the fingers and toes in children: clinical observation of 50 cases.
    Japan Journal of Allergology March 1967, 16 (3): 178-222.

  • T. Kawasaki, F Kosake, S Okawa, I Shigematsu, and H. L. Yanagawa:
    A new infantile acute febrile mucocutaneous lymph node syndrome (MLNS) prevailing in Japan. Pediatrics, Evanston, Illinois, 1974, 54: 271-6.
  • Jane C. Burns, Howard I. Kushner, John F. Bastian, Hiroko Shike, Chisato Shimizu, Tomoyo Matsubara, Christina L. Turner:
    Kawasaki disease: A brief history. Pediatrics, August 2000, 106 (2): E27.

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