Differential diagnosis of Kawasaki disease

	Kawasaki disease	Toxic shock syndrome	Streptococcal scarlet fever	Stevens-Johnson syndrome	Systemic-onset JIA
Age (years)	Usually <5	Usually >10	Usually 2 to 8	All ages	2 to 5
Fever	Persistent	Usually <10 days	Variable, usually <10 days	Prolonged	Prolonged
Eyes	Nonexudative conjunctivitis, limbal sparing, anterior uveitis	Conjunctivitis	Normal	Exudative conjunctivitis, keratitis	Normal
Oral mucosa	Diffuse erythema, "strawberry tongue"	Erythematous	Pharyngitis, "strawberry tongue"	Erythema, ulceration, pseudomembrane formation	Normal
Peripheral extremities	Erythema of palms and soles, indurative edema, periungual desquamation	Swelling of hands and feet	Flaky desquamation	Normal	Arthritis
Rash	Erythematous polymorphous; targetoid or purpuric in 20%	Erythroderma	Papular erythroderma Pastia's lines, circumoral palor	Target lesions	Transient, salmon, pink
Cervical lymph nodes	Nonpurulent swelling	Normal	Painful swelling	Normal	Diffuse adenopathy
Other	Arthritis	Mental status changes, coagulopathy, shock	Throat culture positive for group A Streptococcus	Arthralgia, associated herpesvirus infection (30 to 75%)	Arthritis, pericarditis
Characteristic lab results	Systemic inflammation, anemia, transaminitis	Thrombocytopenia	Positive throat culture	Associated herpesvirus infection 30 to 50%	Systemic inflammation, anemia

JIA: juvenile idiopathic arthritis.

Adapted from: Yanagihara R, Todd JK. Acute febrile mucocutaneous lymph node syndrome. Am J Dis Childhood 1980; 134:603.

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