albumin ≤3 g/dL, anemia for age, elevated alanine aminotransferase, platelets ≥450,000/mm3 after days of illness, white blood cell count ≥15,000/mm3, and urine ≥10 white blood cells per high-power field If the child has more than three supplemental laboratory criteria, and a positive echocardiogram ( Table 101.19 ), then treatment for KD is recommended In children with fewer than three supplemental laboratory criteria and a negative echocardiogram, KD is unlikely, but serial clinical and laboratory re-evaluation is recommended if fevers persist TABLE 101.18 CLINICAL FINDINGS CONSISTENT WITH KAWASAKI DISEASE Cardiovascular findings Congestive heart failure, myocarditis, pericarditis, valvular regurgitation Coronary artery abnormalities Aneurysms of medium-size noncoronary arteries Raynaud phenomenon Peripheral gangrene Musculoskeletal system Arthritis, arthralgia Gastrointestinal tract Diarrhea, vomiting, abdominal pain Hepatic dysfunction Hydrops of gallbladder Central nervous system Extreme irritability Lethargy Aseptic meningitis Sensorineural hearing loss Genitourinary system Urethritis/meatitis Other findings Erythema, induration at Bacille Calmette–Guerin (BCG) site Anterior uveitis (mild) Desquamating rash in groin It should be noted that special consideration is given to febrile infants ≤6 months of age It is recommended that these young infants have a baseline echocardiogram if febrile for days or longer, even if there are no other clinical manifestations of KD present If the echocardiogram is positive ( Table 101.19 ), then treatment is started If the echocardiogram is negative, then supplemental laboratory studies should be