<s>[INST] Granddaughter, 5 years old, has a spiking fever 104-105, which is managed with tylenol.  Tests are back - nostrep, no meningitis, pneumonia in one lobe of left lung, thinking of Kowasaki even though they've only seen 1 case in 20 years.  Great hospital in Bowling Green, KY. [/INST] Hi, When there is definite evidence of pneumonia in the left lung, then I do not think we need to consider an alternative diagnosis like Kawasaki disease as we have a focus for fever here. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Sumanth Amperayani, Pediatrician, Pulmonology </s>