To the Editor.
—We read with interest the article in the Archives by Drs Lee and Vaughan describing Kawasaki disease (KD) (mucocutaneous lymph node syndrome) in a young adult (139:104-105, 1979). Since KD is a syndrome for which there are no diagnostic laboratory tests, the clinical picture is the key to making the diagnosis. The clinical picture in this case, although it meets the stated criteria of KD,1-3 is not otherwise consistent with the usual course of illness. Patients with KD generally do not respond to antibiotic therapy as this patient appeared to. We have not examined patients with KD in whom the five days of fever were not continuous, nor in whom a rash preceded onset of fever (or in this case recurrence of fever, assuming the temperature scale in their Figure is incorrect) or conjunctival injection by more than 24 to 48 hours. Fever is usually the
Anderson LJ, Morens DM, Hurwitz ES. Kawasaki Disease in a Young Adult. Arch Intern Med. 1980;140(2):280. doi:10.1001/archinte.1980.00330140138038