Kawasaki Disease

Kawasaki disease is a rare type of vasculitis, which involves inflammation of the blood vessels, including the arteries, veins and capillaries. Although the disease can affect children of all ages, it’s more common among children under five years old. Boys and children of Asian descent are more likely to develop Kawasaki disease.  

One of the first symptoms of Kawasaki disease is a high spiking fever (102 °F to 104 °F), which can last between five days to two weeks. 
Other common signs include:

• Swollen lymph nodes in the neck (usually only on one side).
• Skin rashes (not blisters) on the middle of the body and genital area.
• Red, chapped or cracked lips and/or red, swollen tongue.
• Red, swollen palms and soles of the feet.
• Bloodshot or red eyes (without pus or drainage).
• Irritability.
• Sore throat, cough and/or runny nose.
• Joint pain and swelling, often on both sides of the body.
• Diarrhea, vomiting and/or abdominal pain.

A few weeks after symptoms begin, the skin of the fingers and toes may peel, sometimes in large sheets. 

With early diagnosis and treatment, most children fully recover within a few weeks without further complications. If untreated, inflammation of the arteries that supply blood to the heart can cause problems and, less frequently, life-threatening complications such as heart attack and internal bleeding. Though rare, these complications will require long-term care and treatment from a doctor who specializes in treating heart disease in children (pediatric cardiologist).  

A pediatrician may be the first doctor to start figuring out what’s causing the symptoms. In general, a child has a fever lasting longer than four days and four other symptoms before being diagnosed with Kawasaki disease. 

Diagnosis also involves ruling out other diseases with similar symptoms (i.e., juvenile idiopathic arthritis, scarlet fever). To do so, the doctor may order various imaging tests (i.e., echocardiograph, chest X-ray) or blood tests. An EKG (electrocardiogram), which records the heart’s electrical activity, can also help with diagnosis. 

Treatment should start immediately after diagnosis and will usually require a hospital stay. The standard treatment is high doses of immunoglobulin (a protein found in blood plasma) to lower the risk of heart problems and high doses of aspirin to combat blood vessel inflammation. Immunoglobin is given through the veins. 

Symptoms typically subside within 24 hours of treatment.  After initial treatment and once the fever goes down, a child may need to take a low-dose aspirin for at least six weeks to prevent blood clotting. Follow-up tests to monitor heart health may also be needed.

Without treatment, Kawasaki disease lasts an average of 12 days, though long-term heart complications may show up later. Children who develop heart problems will need to see a pediatric cardiologist and may require medication. Rarely, surgery will be necessary correct heart damage.  

Although most children make a full recovery, many doctors recommend getting an echocardiogram every one to two years to screen for heart problems. Adopting healthy lifestyle habits, like getting regular exercise and eating a heart-healthy diet, can lower the risk of developing heart disease and complications. 

Children who receive immunoglobulin during treatment may need to wait at least 11 months before getting a vaccine to make sure that it is effective.