Questionnaire/history: Phase 1: acute (weeks 1-2): High temperature (38+°C, up to 40°C)? - Not responding to antibiotics or medicines typically used to reduce a fever, such as ibuprofen or paracetamol? - Lasting for at least 5 days, but can last for around 11 days (3-4 weeks) without proper treatment? Rash? - Morbilliform (measles-like), maculopapular, erythematous or target-like, persistent over days or evanescent, with skin may peeling in the convalescent phase? Skin at fingers and toes red and hard and hands and feet swell up and become tender and painful (maybe)? Redness of the bulbar conjunctivae (whites of the eyes) without exudate or stickiness (bilateral conjunctival injections)? Red or cracked lips? Redness inside of mouth or throat? Red, swollen tongue covered in small lumps (also known as 'strawberry tongue')? Firm swelling of the hands and feet, sometimes including the fingers and toes, with redness of the palms and soles, periungual desquamation (peeling of skin around the fingernails) may occur during the convalescent phase (peripheral limb signs)? Swollen lymph gland(s) at neck (at least 1.5 cm)? Phase 2: sub-acute (weeks 2-4): Abdominal pain? Vomiting? Diarrhoea? Urine that contains pus? Feeling drowsy and lacking energy (lethargic)? Headache? Joint pain and swollen joints? Yellowing of the skin and the whites of the eyes (jaundice)? Peeling skin on the fingers and toes, and sometimes also on the palms of the hands or the soles of the feet? Phase 3: convalescent (weeks 4 to 6): Lack of energy? Becoming easily tired? Past medical history? Current medication? Drug allergies? Examination: Temperature? Rash (as above)? Eye signs (as above)? Oral signs (as above)? Peripheral limb signs (as above)? Swollen lymph node(s) in the neck? Images Diagnosis Temperature of 38+°C for at least 5 days? + at least 4 key symptoms: - Rash (as above)? - Eye signs (as above)? - Oral signs (as above) - Peripheral limb signs (as above) - Swollen lymph node(s) in the neck (as above) Management Referred to paediatric A&E Reference(s): American Family Physician (2015): Diagnosis and Management of Kawasaki Disease BMJ Journals (2012): Management of Kawasaki disease Sheffield Children’s (NHS) Foundation Trust (2017): Diagnosis and Management of Kawasaki Disease Information for patient/carer(s): NHS Health A to Z: Kawasaki Syndrome Patient UK: Kawasaki Syndrome