Kawasaki Disease Criteria Calculator

Diagnoses the Kawasaki syndrome in pediatric patients with fever onset and other symptoms.

Below the calculator, there is more information on the phases of the disease and about fever in children.


The Kawasaki disease criteria calculator aids diagnosis of the syndrome in infants and children based on one major criterion (fever characteristics) and six minor criteria.

It accounts for the compulsory and optional criteria in the National Institute for Health and Care Excellence (NICE) and the diagnosis rule for positivity.


The threshold of this diagnostic criteria states that the major and at least 4 of the minor criteria must be present for positive diagnosis of Kawasaki syndrome.

The condition (affecting children under the age of 5) develops over a six-week period on average and goes through 3 phases:

■ Phase 1 – Acute onset of symptoms (week 1 – 2);

■ Phase 2 – Subacute phase (week 2 – 4);

■ Phase 3 – Convalescent phase (week 4 – 6).

The characteristic symptoms are: long lasting fever (more than 5 days), rash, swollen glands, dry lips, red extremities and eyes.

Diagnosed and treated in time, the condition resolves in 6 to 8 weeks, heart complications (acquired heart disease) may appear in under 5% of cases.


1

Required criteria – select if applies!

2

Other criteria – select any that apply!

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Steps on how to print your input & results:

1. Fill in the calculator/tool with your values and/or your answer choices and press Calculate.

2. Then you can click on the Print button to open a PDF in a separate window with the inputs and results. You can further save the PDF or print it.

Please note that once you have closed the PDF you need to click on the Calculate button before you try opening it again, otherwise the input and/or results may not appear in the pdf.


Kawasaki disease is also known as the mucocutaneous lymph node syndrome and is one of the rare conditions affecting children under the age of 5.

As a self-limited condition it develops with acute inflammatory manifestations, the first of which is fever for more than five days.

 

Criteria for diagnosis

Kawasaki disease criteria calculator consists of one major and 6 minor criteria, the major one being compulsory for positive diagnosis. Any 4 or more of the 6 minor are also required in order to confirm the disease.

Required criteria: Fever for at least five days generally high and spiking (often to 40° C or more), persisting for one to two weeks or longer if left untreated.

Minor criteria are the following:

■ Distinctive changes in extremities that include redness, swelling and induration of the hands and feet. One to three weeks after the onset of fever, desquamation of the fingers and toes may occur. One to two months after the onset of fever Beau's lines (white lines across the fingernails) may appear.

■ Polymorphic exanthema present on the trunk and extremities in a variety of forms: urticarial exanthem, a morbilliform maculopapular eruption (occasionally with target lesions) or a diffuse scarlatiniform rash. Bullae and vesicles are not seen. The rash usually appears within five days after the onset of fever.

■ Bilateral bulbar conjunctival injection that is not associated with an exudate and is in most cases painless.

■ Changes in aspect of lips and oral cavity including: strawberry tongue, redness and cracking of the lips, and erythema of the oropharyngeal mucosa, without any ulcerative lesions.

■ Cervical lymphadenopathy that is usually unilateral, slightly tender, firm nodes, at least one with a diameter of 1.5 cm or greater.

■ Exclusion of other diseases with similar findings.

For the last minor criteria, differential diagnosis focuses on eliminating other conditions with similar symptoms such as: measles, scarlet fever, toxic shock syndrome, glandular fever or viral meningitis.

 

Kawasaki disease phases

The characteristic symptoms are: long lasting fever (more than 5 days), rash, swollen glands, dry lips, red extremities and eyes.

There are three phases of the disease, synthetized in the table below:

Phase Timeline Manifestations
Phase 1 (Acute onset of symptoms) Week 1-2 High fever (unresponsive to usual antipyretic antibiotics)
Blotchy red rash (spreading towards torso and extremities, without blisters)
Swollen lymph glands
Swollen mouth and throat (strawberry tongue)
Bilateral conjunctival injection
Phase 2 (Subacute phase) Week 2-4 Less severe than phase 1, fever subsides
Peeling skin on extremities (fingers and toes)
Vomiting, Diarrhea
Abdominal pain, Jaundice
Joint pain
Phase 3 (Convalescent phase) Week 4-6 Complications are less likely to occur from now on

Diagnosis consists of physical examination, application of NICE criteria and evaluation of symptoms. Blood tests may be used to search for infection markers (check WBC count).

Diagnosed and treated in time (within 10 days of symptom onset), the condition resolves in 6 to 8 weeks. Left untreated it may lead to complications (under 5% of cases) of cardiovascular nature (acquired heart disease) due to blood vessel inflammation.

 

Fever in pediatric patients

In infants and children, fever is a common symptom of many infectious and inflammatory conditions, as a response of the body’s immune system. In the case of infants, high fever can pose serious threat to life, emergency medical assistance should be sought for:

■ Under 3 month old infants with a temperature of 38° C (101° F) or above;

■ 3 to 6 month old infants with a temperature of 39° C (102° F) or above.

These are some examples of diseases with fever onset:

■ Upper respiratory tract infections (RTIs);

■ Tonsillitis;

■ Whooping cough;

■ ENT infections;

■ Roseola;

■ Kidney or urinary tract infections (UTIs).

 

References

1. Newburger JW, Takahashi M, Gerber MA, Gewitz MH, Tani LY, Burns JC, Shulman ST, Bolger AF, Ferrieri P, Baltimore RS, Wilson WR, Baddour LM, Levison ME, Pallasch TJ, Falace DA, Taubert KA; Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease; Council on Cardiovascular Disease in the Young; American Heart Association; American Academy of Pediatrics. Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Circulation. 2004; 110(17):2747-71.

2. Dajani AS, Taubert KA, Gerber MA, Shulman ST, Ferrieri P, Freed M, Takahashi M, Bierman FZ, Karchmer AW, Wilson W, et al. Diagnosis and therapy of Kawasaki disease in children. Circulation. 1993; 87(5):1776-80.

3. Sanchez-Manubens J, Bou R, Anton J. Diagnosis and classification of Kawasaki disease. J Autoimmun. 2014; 48-49:113-7.


App Version: 1.0.1

Coded By: MDApp

Specialty: Allergy and Immunology

System: Immune

Objective: Diagnosis

Type: Criteria

No. Of Criteria: 7

Article By: Denise Nedea

Published On: March 16, 2017 · 08:45 AM

Last Checked: March 16, 2017

Next Review: March 10, 2018