title: Kawasaki disease--the importance of prompt recognition and early referral.
abstract: BACKGROUND
  Kawasaki disease is an acute, febrile vasculitis of childhood that affects medium sized arteries, particularly the coronary arteries. Consequently, it is the leading cause of paediatric-acquired heart disease in developed countries. It is important to have a high index of suspicion for Kawasaki disease in any child with prolonged fever of unknown origin and to refer to a paediatric facility promptly, as timely treatment reduces coronary artery damage.
  
  
  OBJECTIVE
  To provide an evidence based review that will help guide the safe and timely recognition, referral and management of typical and incomplete Kawasaki disease.
  
  
  CONCLUSIONS
  Kawasaki disease is most common in children aged 6 months to 4 years. A high index of suspicion is needed to consider the diagnosis. There are specific diagnostic criteria, though incomplete Kawasaki disease may occur where the child does not meet all diagnostic criteria. There may be co-existing illnesses, which make the diagnosis more difficult. Persistent fever, skin manifestations and extreme irritability may be some cues to consider the diagnosis. If there is strong clinical suspicion the child should be referred, as early treatment significantly decreases the risk of long term cardiac artery damage.
authors.affiliation: Royal Children's Hospital, Melbourne, Victoria, Australia. daniel.golshevsky@rch.org
authors.forename: Daniel
authors.initials: D
authors.lastname: Golshevsky
authors.forename: Michael
authors.initials: M
authors.lastname: Cheung
authors.forename: David
authors.initials: D
authors.lastname: Burgner
mesh_terms: D003937:Diagnosis, Differential; D019468:Disease Management; D006801:Humans; D009080:Mucocutaneous Lymph Node Syndrome / Q000175:diagnosis* / Q000628:therapy; D012017:Referral and Consultation