Kawasaki disease is a disease of acute vascular inflammation of unknown etiology and HDL is a known risk factor of vascular damage. So far, there is no specific serum marker for KD. The previous study has shown a remarkable change of serum HDL in the patients with KD. To find whether changes in serum HDL level is a specific serum marker for early diagnosis of KD, we measured the concentration of HDL, LDL, TC, TG and CRP immediately after admission and one week later in three groups of patients (56 patients with KD, 38 patients with clinical viral infection, and 42 patients with bacterial infection). There was a significant decrease of HDL and increase of TG immediately after admission in three groups of patients. HDL and TG did not return to normal one week later. HDL level is more adversely affected in severe diseases than in mild diseases. Our results indicated that low HDL level is noted in various acute infection and is not a specific serum marker in the early stage of Kawasaki disease. It is interesting that low HDL is a universal phenomenon in this series. Further research is needed to explain the mechanism of lipid alterations and its consequences.