Prolonged Refractory High Fever

  • Ross Petty
  • Farhad Salehzadeh


  • Vasculitis of the coronary arteries is a life-threatening complication of Kawasaki disease (KD) and is detected in echocardiography of up to one-quarter of the patients

  • Younger patients are less likely to meet the classic criteria of KD and are also at greatest risk of developing coronary artery abnormalities

  • In a child with high fever and 2 or 3 criteria for the diagnosis of Kawasaki disease, or an infant with 7 days or more of unexplained fever, a serum CRP <3 mg/dL or ESR < 40 mm/h both suggest a low probability of KD

  • Treatment with aspirin and intravenous immunoglobulin should be initiated promptly in hospital in a child with KD or in children in whom the diagnosis is strongly suspected, even if criteria for diagnosis are not fulfilled


Kawasaki disease Echocardiography CRP ESR 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Ross Petty
    • 1
  • Farhad Salehzadeh
    • 2
  1. 1.Pediatric RheumatologyUniversity of British ColumbiaVancouverCanada
  2. 2.Pediatric RheumatologyBouali Children’s Hospital, ARUMSArdabilIran

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