Diagnostic criteria and diagnostic approach

The diagnostic criteria described by Dr. Kawasaki have been used, with some modification, since the original description of the disease [5] (Tab. 1). Children with four or more principal criteria and at least 4 days of fever can be diagnosed on day 4. If fewer than four principal criteria are observed, KD may be diagnosed with the appearance of coronary artery abnormalities (CAA). With increasing experience, it became apparent that a significant minority of infants and children were not identified by the classic diagnostic criteria. This was especially true for infants < 6 months of age who often presented with less than the required criteria in what became known as "atypical" or more properly "incomplete" KD. The most recent guidelines have included an algorithm for the evaluation of suspected incomplete KD that incorporates refined clinical assessment, laboratory tests and echocar-diographic results into the diagnostic equation [5] (Fig. 1).

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