Acute nonsuppurative transient cervical lymph node swelling, a typical sign of Kawasaki disease, is most prominent in the anterior neck, with a diameter of about 1.5 cm or more, mostly appearing unilaterally, with slight tenderness, occurring within 3 days after fever and resolving spontaneously after a few days. The etiology of acute nonsuppurative transient cervical lymph node swelling is not clear. The disease is somewhat epidemic and land-locked, with clinical manifestations such as fever and rash, presumably related to infection. In 1986, an increase in reverse transcriptase activity in peripheral blood lymphocyte culture supernatant was reported, suggesting that the disease may be caused by a retrovirus. However, most studies have not obtained consistent results. Mycoplasma, rickettsia, and dust mites have also been proposed as the etiologic agent of the disease, but this has not been confirmed. Environmental pollution or chemical sensitization has also been considered as a possible cause of the disease. Diagnosis of acute nonsuppurative transient cervical lymph node swelling is mainly through symptoms, commonly persistent fever for 5 to 11 days or longer (2 weeks to 1 month), with temperature often reaching 39°C or higher, and ineffective antibiotic therapy. Bilateral conjunctival congestion, flushing of the lips and mouth with chapping or bleeding, and a prune-like tongue are commonly seen. There is hard edema in the hands, early flushing of the palms and soles, and after 10 days, characteristic large flaky peeling of the ends of the toes, appearing at the skin junction of the nail bed. There is also acute nonsuppurative transient cervical lymph node swelling, most prominent in the anterior neck, about 1.5 cm or more in diameter, mostly appearing unilaterally, with slight tenderness, occurring within 3 days after the onset of fever and resolving spontaneously after a few days. Soon after the onset of fever (about 1 to 4 days), a maculopapular or erythematous rash, or occasionally a prickly rash-like rash, mostly on the trunk, without herpes or crusts, will appear, and will subside in about a week. Other symptoms often include heart damage, with symptoms of myocarditis, pericarditis, and endocarditis. Patients have an accelerated pulse, and on auscultation, tachycardia, gallop rhythm, and low heart sounds may be heard. Systolic murmurs are also more frequently present. Valvular insufficiency and heart failure may occur. Echocardiography and coronary angiography may reveal coronary aneurysms, pericardial effusion, left ventricular enlargement, and mitral valve insufficiency in most patients, and an enlarged heart shadow may be seen on chest X-ray. Occasionally, joint pain or swelling, cough, runny nose, abdominal pain, mild jaundice, or signs of aseptic encephalomyelitis may be seen. In the acute phase, about 20% of cases present with flushing and desquamation of the perineal and perianal skin and reappearance of erythema or crusting at the original site of BCG vaccination 1 to 3 years ago. In the recovery phase, cross-groove spinning is seen on the nails. The duration of the disease varies. The first phase of the disease is the acute febrile phase, generally lasting 1 to 11 days, with the main symptoms appearing one after another after fever, and severe myocarditis may occur. The second phase of the disease is the subacute phase, generally lasting 11 to 21 days, with most of the body temperature dropping, symptoms relieved, and membranous peeling at the ends of the fingers and toes. Severe cases may still have persistent fever. Coronary aneurysms occur, which can lead to myocardial infarction and aneurysm rupture. Most patients enter the third stage, recovery, in the fourth week, usually for 21-60 days, when clinical symptoms subside and gradually recover if there is no obvious coronary artery lesion; with coronary aneurysm, it can still continue to develop and myocardial infarction or ischemic heart disease can occur. A few patients with severe coronary artery aneurysm enter the chronic stage, which can be prolonged for several years, leaving coronary artery stenosis, angina pectoris, cardiac insufficiency and ischemic heart disease, which can be life-threatening due to myocardial infarction.