This disorder is virtually always accompanied by fever for more than 5 days. The fever has no identifiable cause
(fever of unknown origin) and occurs without the com¬mon manifestation of an upper respiratory tract viral infec¬tion or flu-like illness. The diagnosis is entertained if fever of unknown origin is accompanied by at least four of the following:
1. Bilateral conjunctival redness, injection
2. Inflamed throat, redness of the tongue (strawberry tongue), fissuring of the lips
3. Redness of the palms and soles of the feet, swelling, edema of the hands and feet
4. Body rash
5. Enlargement of lymph nodes around neck (cervical lymphadenopathy).
Because these features are much more common in the Far East, the condition is recognized as part of a mucocutaneous lymph node syndrome. The cardiac part of this syndrome is now widely referred to as Kawasaki disease.
Other symptoms are not necessary for the diagnostic conclusions including joint pains, diarrhea, vomiting, bowel pain, and aseptic meningitis. The disease may be confused with and must be distinguished from the following:
1. Streptococcal sore throat and streptococcal infections
2. Staphylococcal toxin-mediated illness
3. Viral infections such as adenovirus, enterovirus, and measles

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