Kawasaki disease (KD) is a paediatric illness characterised by prolonged high fever, mucocutaneous lesions and lymphadenopathy. It is potentially fatal as coronary arteritis occurs in up to a third of affected children. We present a seven-year-old child who was admitted to hospital with neck pain and fever. Despite intravenous antibiotic therapy and a quinsy right tonsillectomy on the sixth day after admission, the patient's symptoms persisted. With the appearance of further signs and symptoms the diagnosis of KD was made two days after operation. The patient's symptoms resolved with aspirin and intravenous gammaglobulin therapy. A literature review of the various aspects of KD is presented.