Do you know the common misunderstandings in the diagnosis of Kawasaki disease?

What are the common misunderstandings in the diagnosis of Kawasaki disease? In fact, after suffering from Kawasaki disease, it is easy to be confused with many other diseases. Children with the disease will have common symptoms such as fever and flushed lips, but these symptoms are not specific. There are several diseases that have certain similarities with Kawasaki disease in symptoms. In order to help everyone distinguish them, let the editor introduce in detail several diseases that are easily confused with Kawasaki disease.

1. The differences between this disease and scarlet fever are: ① The rash only begins on the third day after the onset of the disease; ② The rash morphology is similar to measles and erythema multiforme; ③ The most common age of onset is infants and young children; ④ Penicillin is ineffective.

2. The differences between this disease and juvenile rheumatoid arthritis are: ① The fever period is shorter and the rash is more transient; ② The hands and feet are hard and swollen, and the plantar erythema is often seen; ③ The rheumatoid factor is negative.

3. The differences from exudative erythema multiforme are: ① There is no purulent secretion and pseudomembrane formation in the eyes and lips; ② The rash does not include blisters and crusts.

4. The differences from systemic lupus erythematosus are: ① The rash is not obvious on the face; ② The total white blood cell count and platelets are generally elevated; ③ Antinuclear antibodies are negative. ④ The most common age is infants and boys.

5. The differences from infantile polyarteriosclerosis nodularis and exanthematous viral infections are: ① The lips are flushed, cracked, and bleeding, showing a bayberry tongue; ② The hands and feet are hard and swollen, and the plantars are often flushed and membranous peeling of the fingertips appears in the later stage; ③ There is no edema or secretion of the conjunctiva; ④ The total white blood cell count and the percentage of granulocytes are increased, with nuclear left shift; ⑥ The erythrocyte sedimentation rate and C-reactive protein are significantly increased.

6. The differences from acute lymphadenitis are: ① The enlargement and tenderness of the cervical lymph nodes are mild, and there is no redness or swelling of the local skin and subcutaneous tissue; ② There are no purulent lesions.

7. The differences from rheumatic carditis are: ① Prominent coronary artery lesions; ② No meaningful heart murmurs; ③ The age of onset is mainly infants and young children.

The above are seven diseases that are easily confused with Kawasaki disease. These diseases have similarities with Kawasaki disease, but also have certain differences. I hope everyone can understand the difference between Kawasaki disease and these diseases, so that they can be distinguished during diagnosis. Only with a correct diagnosis can the right medicine be prescribed to achieve the desired treatment effect.