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Diagnosis of Kawasaki

From Dr GB Winstock

London SW18

I was perplexed by the case of the child who had a fever for four days and other symptoms (Clinical, 23 March).

Kawasaki disease, according to the article, requires a fever of more than five days and yet it was the quoted diagnosis.

The author replies: The diagnosis of Kawasaki disease was made by taking into account the features of conjunctivitis,

skin rash, large lymph nodes and swollen lips, together with the four days' high temperature.

The textbooks all say five days' temperature, but in practice you would not wait

if the child had other

features that supported the diagnosis.

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