Pitfalls

Kawasaki disease is generally considered a rare disease however it is increasingly common with more hospital admissions than measles or bacterial meningitis.
A high index of suspicion is warranted in all children with prolonged fever.
The clinical principal features may have appeared and disappeared at the time of assessment.
A concurrent infection does not exclude Kawasaki disease. Respiratory viruses such as respiratory syncytial virus, metapneumovirus, coronaviruses, parainfluenza viruses, or influenza viruses have been shown to co-exist with Kawasaki disease
Desquamation of the fingers and toes is a late sign and its absence does not exclude the diagnosis.
Normal echocardiography does not exclude Kawasaki disease.
Delayed treatment due to delayed diagnosis increases the risk of cardiac complications.