Which among the following diagnostic criterion is most characteristic of Kawasakis disease
Ans) a (Periungual desquamation) Ref Nelson 18th ed p 1039Bilateral bulbar conjunctival injection without exudates and cervical lymphadenopathy are present in the classical criterion for diagnosis. So both B and C can be excluded. Splenomegaly is not mentioned in the GI manifestations of Kawazakis disease.Usually cervical lymphadenopathy is seen in about 30% of patients where as rest of the diagnostic criterias are seen in more than 80% of patients For classic Kawasaki disease, the diagnostic criteria require the presence of fever for at least 5 days and at least four of five of the other characteristic clinical features of illness.CLASSIC CLINICAL CRITERIAFever persisting at least 5 daysPresence of at least 4 principal features:Changes in extremitiesAcute: Erythema of palms, soles; edema of hands, feetSubacute: Periungual peeling of fingers, toes in weeks 2 and 3Polymorphous exanthemaBilateral bulbar conjunctival injection without exudatesChanges in lips and oral cavity: Erythema, lips cracking, strawberry tongue, diffuse injection of oral and phyryngeal mucosaeCarvical lymphadenopathy (>1.5 cm diameter) usually unilateral Gastrointestinal tract manifestation of Kawazaki disease* Diarrhea, vomiting, abdominal pain* Hepatic dysfunction* Hydrops of gallbladder
Periungual desquamation
Generalised lymphadenopathy
Splenomegaly
Exudative conjunctivitis
Miscellaneous