University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository


Urgent Care


Elyse Watkins


Kawasaki Disease (KD) is a panvasculitis disease that is the leading cause of coronary artery disease and heart disease acquired in childhood. It is a diagnosis that depends heavily on the clinician’s ability to recognize the clinical manifestations. Lab tests and other tests can aid clinicians with the diagnosis but do not confirm the presence of KD. The key to efficient diagnosis is recognizing the clinical diagnostic criteria for KD and immediately getting the patient into treatment. The diagnosis involves the presence of fever for five days or more, along with four out of five clinical findings listed by the American Heart Association (AHA) and other diagnoses with similar symptoms ruled out. If only two or three criteria are met with a fever for five or more days, it is considered incomplete KD. Although KD can be a self-limited disease, morbidity and mortality are severely increased, especially for children inadequately treated. Complications of KD and delayed therapy include coronary artery aneurysms, which their size is dependent on how long a patient goes without treatment, and resistance to intravenous immunoglobulins (IVIG), which is the mainstay of treatment for KD at this time along with high-dose aspirin. By presenting a case of a 2-year-old male diagnosed with KD in an urgent care setting without the adequate diagnostic criteria met, this article aims to illustrate that not all criteria may be met in the setting of KD but if identified early, may lead to improved outcomes. Keeping this in mind will allow clinicians to more easily and promptly diagnose KD.


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