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I would certainly agree with the comment by Dr Anderson et al that, since Kawasaki disease is a syndrome for which there are no diagnostic laboratory tests, the clinical picture is the key to making the diagnosis. I would, however, like to make a few comments concerning their conclusion that the clinical picture in this case is not otherwise consistent with the usual course of illness.
Unfortunately, there are a couple of points concerning the course of fever that need to be clarified. There was an obvious error in transcription of the temperature chart as depicted in the graphic summary of the case. As noted in the clinical history, the temperature on the first admission was 38.9 °C, and on the second admission, 38.3 °C on the admission examination. It is also true that while the patient was receiving penicillin therapy during the first admission, a decrease in the temperature
Lee TJ. Kawasaki Disease in a Young Adult-Reply. Arch Intern Med. 1980;140(2):280–281. doi:10.1001/archinte.1980.00330140138039
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