Which features of Kawasaki disease suggest an infectious etiology?

Updated: Jul 29, 2018
  • Author: Tina K Sosa, MD; Chief Editor: Russell W Steele, MD  more...
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Answer

Features of KD that raise concern for an infectious etiology include the occurrence of epidemics primarily in late winter and spring, with 3-year intervals, and the wavelike geographic spread of those epidemics. KD is unusual in infants younger than 4 months, suggesting that maternal antibodies may provide passive immunity. Epidemiologic data suggest, however, that person-to-person transmission of the disease is unlikely.

Some authors have proposed a controversial association of KD with recent carpet shampooing, flooding, the use of a humidifier in the room of a child with an antecedent respiratory illness, [16] and locations near bodies of water. [17] These data have led to a waterborne vector hypothesis.

The overall clinical presentation of patients with KD is similar to that of patients with a viral or superantigenic disease. However, investigations have shown that the immune response in KD is oligoclonal, which is seen as a response to a conventional antigen, rather than polyclonal, as would be found in a superantigen-driven response. [18, 19]


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