Last reviewed:September 2019
Last updated:September  2019

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • polymorphous rash
  • conjunctival injection
  • mucositis
  • skin changes in the peripheral extremities
  • enlarged cervical lymph nodes
  • coronary artery aneurysms
  • fever and extreme irritability

Other diagnostic factors

  • pericarditis with effusion
  • congestive heart failure
  • joint pain or oedema
  • neurological manifestations
  • gastrointestinal manifestations
  • urological manifestations
  • other dermatological manifestations

Risk factors

  • Asian ancestry
  • age 3 months to 4 years
  • male sex

Diagnostic investigations

1st investigations to order

  • FBC
  • serum erythrocyte sedimentation rate (ESR)
  • serum CRP
  • echocardiogram
Full details

Investigations to consider

  • serum LFTs
  • urinalysis
  • chest x-ray
  • electrocardiogram
  • ultrasonography of the gallbladder
  • ultrasonography of the testes
  • lumbar puncture
Full details

Emerging tests

  • magnetic resonance angiography
  • cardiac catheterisation and angiography
Full details

Treatment algorithm

Contributors

Professor of Pediatrics and Chief

Division of Pediatric Rheumatology

LSU Health Sciences Center and Children's Hospital

New Orleans

LA

Disclosures

AG declares that he has no competing interests.

Assistant Professor of Clinical Pediatrics

Department of Pediatric Cardiology

Children's Hospital

New Orleans

LA

Disclosures

JK declares that he is a paid consultant for Axia Medical Solutions, a small skincare company from Carlsbad, CA.

Peer reviewersVIEW ALL

Professor of International Child Health

Imperial College London

London

Disclosures

ML declares that he has no competing interests

Editor in Chief

Journal of Clinical Pediatrics

Department of Pediatrics

Division of Infectious Diseases

Ochsner Children's Health Center

New Orleans

LA

Disclosures

RWS declares that he has no competing interests.

Clinical Professor of Pediatrics

Department of Pediatrics

Oregon Health Science University

Portland

OR

Disclosures

JLE declares that he has no competing interests.

Principal Research Fellow

Murdoch Childrens Research Institute

The Royal Children’s Hospital

Victoria

Australia

Disclosures

DB has received competitive research funding from the National Heart Foundation Australia and from the Agency for Science, Technology and Research of the Singapore Government. He is co-inventor on a patent related to diagnostics submitted through the Genome Institute of Singapore.

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