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Diagnostic Criteria for Kawasaki Disease

Presence of at least five of six conditions:

  1. Fever for five days or more

  2. Bilateral conjunctival injection without exudate

  3. Polymorphous exanthem

  4. Changes in lips and mouth:

  • Reddened, dry, or cracked lips

  • Strawberry tongue

  • Diffuse redness of oral or pharyngeal mucosa

  1. Changes in extremities:

  • Reddening of palms or soles

  • Indurative oedema of hands or feet

  • Desquamation of skin of hands, feet, and groin (in convalescence)

  1. Cervical lymphadenopathy:

  • More than 15 mm in diameter, usually unilateral, single, non-purulent, and painful


Exclusion of diseases with similar presentation:

  • Staphylococcal infection (such as scalded skin syndrome, toxic shock syndrome)

  • Streptococcal infection (such as scarlet fever, toxic shock-like syndrome). Throat carriage of group A streptococcus does not exclude the possibility of Kawasaki disease

  • Measles and other viral exanthems

  • Leptospirosis

  • Rickettsial disease

  • Stevens-Johnson syndrome

  • Drug reaction

  • Juvenile rheumatoid arthritis


Elevated erythrocyte sedimentation rate (ESR), anemia, and thrombocytosis are associated with Kawasaki disease and can support the diagnosis. Coronary artery aneurysms, the most serious consequence of Kawasaki disease, are seen in 20% of untreated patients, and long-term consequences include early atherosclerosis, coronary stenosis, and myocardial infarction.

Related Criteria

Revised ARA Criteria for the Classification of Rheumatoid Arthritis (RA)

Classification Criteria for the Diagnosis of Systemic Lupus Erythematosus (SLE)

Criteria for the Classification of Systemic Sclerosis (Scleroderma)

ACR Criteria for the Classification of Polyarteritis Nodosa (PAN)

ACR Criteria for the Classification of Churg-Strauss Syndrome (CSS)

ACR Criteria for the Classification of Giant-Cell Arteritis

ACR Criteria for the Classification of Hypersensitivity Vasculitis

Revised International Classification Criteria for Sjögren's Syndrome (SS)

1990 Criteria of American College of Rheumatology for the Classification of Takayasu Arteritis

Classification Criteria for Osteoarthritis

Diagnostic Criteria for Relapsing Polychondritis

Criteria for the Classification of Wegener's Granulomatosis (WG)

Diagnostic Criteria for Autoimmune Hepatitis (AIH)

Names and definitions of vasculitis adopted by the Chapel Hill Consensus Conference

Diagnostic Criteria for Mixed Connective Tissue Disease (MCTD)

Criteria for the Classification of the Antiphospholipid Syndrome (APS)



  1. Taubert KA, Shulman ST. Kawasaki disease. Am Fam Physician. 1999 Jun;59(11):3093-102, 3107-8. [Medline]
  2. Stapp J, Marshall GS. Fulfillment of diagnostic criteria in Kawasaki disease. South Med J. 2000 Jan;93(1):44-7. [Medline]
  3. Curtis N. Kawasaki disease. BMJ. 1997 Aug 9;315(7104):322-3. [Medline]

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Created: May 12, 2005
Last Modified: 10/23/2010

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