Dominguez SR, Birkholz M, Anderson MS, et al. - In the diagnostic assessment of Kawasaki disease (KD) in children, researchers assessed differences in treatment practice and compliance with national guidelines. To analyze demographic, laboratory, and treatment data from patients admitted with KD between January 1, 2006 and December 31, 2015, the Pediatric Hospital Information System database was used. Twelve thousand eighty-nine children with KD were diagnosed during the study period. A fraction of children had abdominal imaging (11.5%), neck imaging (5.9%), and lumbar punctures (4.5%); 36.0% of patients received antibiotic therapy. Over the study period, getting pretreatment echocardiograms and the use of steroids and infliximab increased significantly. After failing initial intravenous immunoglobulin (IVIG) monotherapy, 82.0% of patients received a second dose of IVIG, 7.7% received steroids, 6.5% received infliximab, and 3.9% received combination therapy. A higher response rate was seen in those who got infliximab or steroids as second therapy vs those who received only a second IVIG dose. There are opportunities to use echocardiograms earlier in the assessment of children with potential KD. The data suggest superiority in the use of infliximab or steroids in second-line therapy over intravenous immunoglobulin in terms of reducing additional therapy needs. To verify this finding, prospective, controlled studies are required.