Typical age: < 5 years
Systemic symptoms:
(1) fever typically high-spiking with fevers >= 40°C (104°F)
(2) marked irritability
Cardiovascular findings:
(1) gallop rhythm
(2) abnormal ECG (cardiac arrhythmias, prolonged PR interval, abnormal Q wave, prolonged QT interval, ST-T wave changes, other)
(3) myocarditis with cardiomegaly
(4) coronary arteritis which may result in aneurysms
(5) angina pectoris
(6) aneurysms in peripheral arteries
(7) risk of sudden death.
(8) pericardial effusion
Pulmonary findings:
(1) cough
(2) rhinorrhea
(3) pulmonary infiltrate on chest X-ray
(4) pleural effusion
Changes in the head and neck:
(1) bilateral conjunctival injection
(2) strawberry tongue
(3) erythema of the pharynx
(4) erythematous, dry and fissured lips
(5) cervical lymphadenopathy: often node diameter > 1.5 cm
(6) facial nerve palsy (rare)
Dermatologic changes:
(1) rash, primarily on the trunk: maculopapular, scarlatiniform or erythema multiforme; not vesicular
(2) redness and swelling of the hands and feet (during the acute phase)
(3) desquamation of fingers and toes (during subacute phase)
(4) Beau's lines in fingernails during convalescent phase
Musculoskeletal changes:
(1) arthralgias and arthritis
Laboratory findings:
(1) elevation of the erythrocyte sedimentation rate (ESR)
(2) elevation of C-reactive protein (CRP) and other acute phase reactants
(3) leukocytosis
(4) mononuclear pleocytosis in the CSF
(5) thrombocytosis
(6) mild anemia
(7) pyuria of urethral origin
(8) occasional proteinuria
