Golshevsky Daniel, Cheung Michael, Burgner David
Royal Children's Hospital, Melbourne, Victoria, Australia.
Aust Fam Physician. 2013 Jul;42(7):473-6.
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.
To provide an evidence based review that will help guide the safe and timely recognition, referral and management of typical and incomplete Kawasaki disease.
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.
川崎病是一种儿童急性发热性血管炎，累及中等大小动脉，尤其是冠状动脉。因此，它是发达国家儿童获得性心脏病的主要原因。对于任何不明原因长期发热的儿童，高度怀疑川崎病并及时转诊至儿科医疗机构非常重要，因为及时治疗可减少冠状动脉损伤。
提供基于证据的综述，以帮助指导典型和非典型川崎病的安全、及时识别、转诊和管理。
川崎病在6个月至4岁儿童中最为常见。需要高度怀疑才能考虑诊断。有特定的诊断标准，不过非典型川崎病可能出现在儿童未满足所有诊断标准的情况下。可能存在合并疾病，这会使诊断更加困难。持续发热、皮肤表现和极度烦躁可能是考虑诊断的一些线索。如果临床高度怀疑，应转诊患儿，因为早期治疗可显著降低长期冠状动脉损伤的风险。
