What are the differential diagnoses of Kawasaki disease (Mucocutaneous Lymph Node Syndrome)?

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Last updated: March 23, 2025View editorial policy

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Differential Diagnosis for Kawasaki Disease

  • Single Most Likely Diagnosis
    • Scarlet fever: This is a highly likely diagnosis due to the similar presentation of fever, rash, and mucous membrane changes. However, the presence of a strawberry tongue and the absence of a distinct rash pattern can help differentiate Kawasaki disease.
  • Other Likely Diagnoses
    • Viral exanthems (e.g., measles, roseola): These conditions often present with fever and rash, but the specific combination of symptoms and the presence of lymphadenopathy and desquamation in the subacute phase can help distinguish Kawasaki disease.
    • Toxic shock syndrome: This condition can present with fever, rash, and hypotension, but the presence of a clear source of infection and the absence of the characteristic Kawasaki disease criteria can help differentiate the two.
    • Juvenile idiopathic arthritis: This condition can present with fever and rash, but the presence of joint inflammation and the absence of the characteristic Kawasaki disease criteria can help differentiate the two.
  • Do Not Miss Diagnoses
    • Staphylococcal toxic shock syndrome: This condition can present with fever, rash, and hypotension, and can be life-threatening if not promptly recognized and treated.
    • Streptococcal toxic shock syndrome: Similar to staphylococcal toxic shock syndrome, this condition can present with fever, rash, and hypotension, and can be life-threatening if not promptly recognized and treated.
    • Meningococcemia: This condition can present with fever, rash, and shock, and can be life-threatening if not promptly recognized and treated.
  • Rare Diagnoses
    • Systemic lupus erythematosus: This condition can present with fever, rash, and lymphadenopathy, but is relatively rare in children and can be distinguished by the presence of specific autoantibodies and other systemic symptoms.
    • Polyarteritis nodosa: This condition can present with fever, rash, and lymphadenopathy, but is relatively rare and can be distinguished by the presence of specific vascular and systemic symptoms.
    • Infectious mononucleosis: This condition can present with fever, rash, and lymphadenopathy, but is relatively rare in young children and can be distinguished by the presence of specific serologic tests and other systemic symptoms.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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