Kawasaki disease physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dildar Hussain, MBBS [2]

Physical examination of patients with Kawasaki disease is usually remarkable for erythematous rash, irritability, and desquamation of skin and mucous membranes.

Physical examination of patients with Kawasaki disease is usually remarkable for erythematous rash, irritability, and desquamation of skin and mucous membranes.^[1]

• Patients with Kawasaki usually appear lethargic

• High-grade fever

• Erythema
• Edema
• Jaundice may or may not be present
• Desquamation
  • May occur on the palms of the hand and soles of the feet, as well as perianally.
• Rash
  • Limited to groin and lower limbs
  • Pustules, macules, and pustules may be rarely seen
• Beau’s lines are seen as transverse grooves along finger and toe nails

• Strawberry tongue
• Fissuring of lips
• Erythematous oropharynx without tonsillar swelling
• Conjunctival injection
• High frequency sensorineural hearing loss may or may not be present

• Cervical lymphadenopathy
  • Lymph nodes are greater than 15 mm in diameter
• Neck stiffness
  • May indicate aseptic meningitis

• Pneumonitis may be present and is demonstrated by:
  • Fine crackles upon auscultation of the lung apices bilaterally
  • Rhonchi
  • Vesicular breath sounds
  • Expiratory/inspiratory wheezing

• Arrhythmia may or may not be present
• Tachycardia with regular or irregular pulse

• Diarrhea
• Vomiting
• Abdominal pain
• Hepatomegaly / splenomegaly / hepatosplenomegaly

• Orchitis may be present

• Facial palsy may be present

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