Kawasaki disease in a 15-year-old adolescent.

It has been 28 years since Dr. Tomisaku Kawasaki originally described mucocutaneous lymph node syndrome, now known as Kawasaki disease.! First thought to be a benign self-limited febrile illness, Kawasaki disease today is recognized as the most common cause of acquired heart disease in children in the United States. It is almost exclusively an illness of young children about 80 percent of patients are younger than 4 years and the syndrome is unusual after 8 years of age.2 The peak age of Kawasaki disease patients in Japan is from 9 to 11 months, with equal numbers of cases in the first and second years. Studies in the United States and Europe showed that a peak age of Kawasaki disease is 18 to 24 months, older than in Japan.3 Adult Kawasaki disease has received increased recognition, but early reports have been challenged as probably represepting toxic shock syndrome instead. One review of 21 patients with adult Kawasaki disease reported in the English literature accepted only 10 cases as representing this syndrome.4