What is the clinical presentation of the subacute stage of Kawasaki disease?

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

The subacute stage begins when the fevers have abated, and it continues until week 4-6. The hallmarks of this stage are desquamation of the digits, thrombocytosis (the platelet count may exceed 1 million/μL), and the development of CAAs. The risk for sudden death is highest at this stage. 20-40% of patients experience arthralgia or arthritis during this period, both of which tend to favor the large weight-bearing joints. Other characteristics of the subacute stage are persistent irritability, anorexia, and conjunctival injection. 

Persistence of fever beyond 2-3 weeks may be an indication of recrudescent KD. If fever persists, the outcome is less favorable because of a greater risk of cardiac complications.


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