Kawasaki syndrome in the ED.

In a retrospective case review of inpatient and emergency department (ED) records during a 55-month period, 155 hospitalizations for Kawasaki syndrome (KS) were identified, of which 44 were seen in the ED. In 16 cases, KS was already suspected by their private physicians and confirmed in the ED by a KS specialist. In the remaining 28, patients presented initially to the ED. In 18 of these 28 (64%), KS was identified or suspected in the ED. In the other 10, the diagnosis was delayed. In four instances, patients were hospitalized for other reasons. In all cases in which the diagnosis of KS was not made in the ED, viral infections or sepsis were suspected. One child presented to the ED in respiratory arrest and severe bradycardia.