With the increasing incidence of Kawasaki disease year by year, we have seen some changes in the clinical presentation of patients. Strictly using the diagnostic criteria developed 20 years ago to diagnose Kawasaki disease is likely to miss some patients, which is not uncommon in clinical practice. Some patients have atypical manifestations due to treatment confusion or other reasons, some even only have fever and swollen lymph nodes, and elevated white blood cells on laboratory tests, which are usually misdiagnosed as lymphadenitis, and these patients often think of Kawasaki disease only when they have cumulative cardiac manifestations, which is often too late, resulting in coronary artery aneurysms, especially in patients with huge coronary artery aneurysms, which are regretted for life. To this end, in order to reduce the rate of misdiagnosis of such Kawasaki disease, improve clinical management, and reduce the occurrence of related coronary complications, we retrospectively analyzed the clinical data of children with Kawasaki disease admitted to Beijing Children’s Hospital from January 2002 to December 2010, and children with incomplete Kawasaki disease with fever and enlarged lymph nodes in the neck as the first symptoms and misdiagnosed as lymphadenitis as the first misdiagnosed as lymphadenitis In the Incomplete Kawasaki disease IKD group, 31 cases (3.1%) of 1004 children with Kawasaki disease were found to have atypical Kawasaki disease, with fever and enlarged lymph nodes in the neck as the main clinical manifestations. Eight (25.8%) children had unilateral lymph node enlargement, another 8 (25.8%) had bilateral lymph node enlargement, and the remaining children were unilateral and bilateral; 4 (12.9%) of these children also had rash, 6 (19.3%) had lip and mouth changes, 7 (22.6%) had fingertip desquamation, and 10 (32.3%) had conjunctival congestion. In addition, the incidence of coronary artery dilatation, coronary artery aneurysm and giant coronary artery aneurysm in this group of children with atypical Kawasaki disease was 71% (22/31 cases), 16.1% (5/31 cases) and 9.7% (3/31 cases), respectively, which was significantly higher than that of typical patients (28.1%, 4.9% and 1.1%, respectively; P<0.05), suggesting that incomplete Kawasaki disease mistakenly diagnosed as lymphadenitis at the first diagnosis It is suggested that incomplete Kawasaki disease with fever of longer duration, higher incidence of coronary complications and lower inflammatory indexes in laboratory tests than typical Kawasaki disease children should be more vigilant in clinical work, and the diagnosis of Kawasaki disease should be excluded in children with fever combined with lymph node changes to reduce the occurrence of coronary artery lesions due to misdiagnosis or omission.