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Kawasaki disease (KD) is a rare illness. It causes tissue to swell and become inflamed. It can affect the whole body, including the blood vessels. The cause of KD is unknown. KD most often occurs in children under 5 years old. Without treatment, children with KD are at higher risk of developing problems with the coronary arteries. These are the blood vessels that supply blood to the heart. Other areas of the heart may also be affected. With timely treatment, most children recover from KD with no lasting problems.
The most common sign of KD is a fever of 100.4°F or higher. The fever tends to rise and may last at least 5 days. To confirm KD, a child also needs to have at least four of the following:
Swollen lymph nodes
Swollen hands and feet
Red and dry cracked lips
Red tongue with white spots (called “strawberry tongue”)
Your doctor will likely be referred to a pediatric cardiologist. This is a doctor with special training to diagnose and treat heart problems in children. KD is diagnosed based on symptoms. Tests may be done as well. These can include:
Lab tests. Blood and urine samples are taken to check for signs of inflammation. These are also used to help rule out other health problems.
Electrocardiography (ECG or EKG). This test records the electrical activity of the heart. This helps check for problems with heart rhythm and heart structure.
Echocardiography (echo). This test uses sound waves to create a picture of the heart. This can show problems with heart structure and heart function. This can also show problems with the coronary arteries.
Treatment starts as soon as the problem is diagnosed. A hospital stay of a few days or longer may be needed.
The main treatment for KD is medications. These can include:
High-dose gamma globulin. This is given through an IV line. It helps boost the body’s immune system response. It also helps reduce the risk of damage to the coronary arteries and the heart.
High-dose aspirin. This helps reduce inflammation. It also helps reduce the risk of blood clots.
Your child is observed until symptoms improve. Once at home, low-dose aspirin may need to be taken for 4-6 weeks.
Symptoms that return or worsen
Shortness of breath
In an infant under 3 months old, a rectal temerature of 100.4°F (38.0°C) or higher
In a child 3 to 36 months, a rectal temperature of 102°F (39.0°C) or higher
In a child of any age who has a temperature of 103°F (39.4°C) or higher
A fever that lasts more than 24-hours in a child under 2 years old, or for 3 days in a child 2 years or older
A seizure caused by the fever
After treatment, your child’s health should improve. Some symptoms may not resolve for 2-3 weeks. These can include joint pain and peeling skin on the hands and feet.
Going forward, your child may need regular visits with the doctor. Also, routine tests may need to be done to check your child’s heart and blood vessels.
If your child develops heart problems, ongoing care will be needed. The doctor will discuss your child’s health with you. He or she will also tell you more about treatment options for your child.