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Timely diagnosis of Kawasaki disease is often elusive, especially in patients who do not present with at least 5 signs that fulfill the diagnostic criteria.
But early diagnosis and initiation of immunoglobulin therapy are essential to prevent the most ominous sequela: coronary artery damage. These authors from New York University School of Medicine retrospectively compared the medical records of 36 children with Kawasaki disease (23 with classic and 13 with atypical disease) and 7 children who had acute adenoviral infection proven by culture and direct fluorescent antigen (DFA) tests.
Half of the children diagnosed with Kawasaki disease had negative adenovirus cultures and DFAs; the other18 were not tested, including 4 whose cases were atypic…