Chilldren with fever ≥5 days and 2 or 3 compatible clinical criteria^b OR infants with fever for ≥7 days without other explanation^c

Serial Clinical and laboratory reevaluaion if fever persist; echocardiogram if typical peeling^f develops

End

Treat^e

^b See next page for diagnostic criteria and clinical findings of Kawasaki disease.

^c Infants 6 months of age are the most likely to develop prolonged fever without other clinical criteria for Kawasaki disease; these infants are at particularly high risk of developing coronary artery abnormalities.

^d Echocardiography is considered positive for purposes of this algorithm if any of 3 conditions are met: z score of left anterior descending coronary artery or right coronary artery ≥2.5; coronary artery aneurysm is observed; or ≥3 other suggestive features exist, including decreased left ventricular function, mitral regurgitation, pericardial effusion, or z scores in left anterior descending coronary artery or right coronary artery of 2–2.5.

^e Treatment should be given within 10 days of fever onset.

f Typical peeling begins under the nail beds of fingers and toes.