Kawasaki disease is the leading cause of acquired heart disease in developed countries. A rare disease without pathognomonic findings or a diagnostic test, Kawasaki disease should be considered in the differential diagnosis of a child with prolonged fever.

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A 3-year-old previously healthy Hispanic girl is brought to her pediatrician’s office by her mother with a history of 6 days of fever. The fever has been present daily and unremitting despite administration of antipyretic medications. She has been irritable, with decreased appetite. Her mother noticed an erythematous nonpruritic rash covering her torso 1 day after fever onset. She has developed red eyes in the past 2 days. She has no siblings and attends child care.

On examination she is febrile to 102°F (38.9°C) and tachycardic at 140 beats/min. Her blood pressure while crying is 110/60 mm Hg. Her weight is 32 lb...

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