When should Kawasaki disease be suspected?
The clinical features of KD can create a diagnostic dilemma in primary care. It is important that health professionals presented with a febrile child consider KD in their differential diagnosis. A history of immunisation status should always be reviewed, as other childhood illnesses can mimic features of KD (see Box 1).KD should be suspected in any child with a fever lasting more than 5 days ^vho also shows four or more of the cardinal clinical features listed in Box 2 in whom there is no other reasonable alternative diagnosis (Newburger and Burns, 1999; Maconochie, 2004; NICE, 2007). Although studies have shown an increased risk among family members (tenfold increased risk in siblings; twofold if parents have suffered from KD), the actual overall risk in clinical practice is so low that it needs to weighed as to whether it is worth informing parents about it unless specifically asked. The