The cause of Kawasaki disease (KD) is still unknown. Evidence is available to support both a conventional infection, as well as a superantigen-mediated illness. The cases of two children who were hospitalized with scald injuries are presented. Both patients became febrile without an infectious source and subsequently developed typical KD, that responded to treatment with intravenous immunoglobulin, without cardiac sequelae. The temporal association between the thermal injury and the onset of KD could be explained by the entry of an infectious agent(s), toxin or superantigen through the compromised skin barrier, leading to an inflammatory vasculitis and the clinical manifestations of KD.