I saw my first case of Kawasaki’s disease as a med student on peds–I was the first person to see the kid, and I was alarmed–skin and mouth lesions, high fever, lymphenodes–miserable very sick child with anxious parents. Kinda scary.
I haven’t seen many cases since, but we talk about it whenever a sick high fever kid rolls in with effects in the skin, mouth and nodes. The red swollen peeling hands and feet are quite striking along with the stomatitis (inflammation of the mouth and lips).
Sometimes we see what are called forme fruste versions, that present as an attenuated or incomplete version. Some of the indicia, not all–but the big thing is the risk to the heart.
That, however is just the front story–the consequences of Kawasaki’s untreated are lethal.
It’s an auto immune thing with the vasculitis that causes aneurysms, weakened bulges of the vessels, and that bad part is the attack on the coronary arteries, vital to the function of the heart.
Here’s an essay that describes this bad boy.