Age-related differences in the course of the acute phase symptoms of Kawasaki disease.

BACKGROUND: Knowledge about age-related differences in the course of the acute phase symptoms is helpful to make an accurate and timely diagnosis of Kawasaki disease (KD). METHODS: We performed a retrospective study involving 100 consecutive patients with KD. Time to the first detection of the principal symptoms was examined. The first day of fever was defined as day 1. RESULTS: Median age was 24 months. In patients >24 months, cervical lymphadenopathy was the earliest symptom other than fever and appeared earlier than in younger patients (2.6 ± 2.2 versus 3.8 ± 1.9 days of illness; P 24 months with cervical lymphadenopathy. Younger patients need close observation because their acute phase symptoms progress rapidly. On the contrary, in older patients, cervical lymphadenopathy often remains the only manifestation for more than a few days and complicates the diagnosis. Recognizing age-specific patterns is useful for accurate and timely diagnosis of KD.