Kawasaki Disease

What Are the Signs & Symptoms of Kawasaki Disease?

The first sign of Kawasaki disease is usually a high fever over 101° Fahrenheit (F) or 38.3° Celsius (C). The fever often lasts more than 4 days and may be as high as 104°F (40°C). Many children are also very fussy or irritable.

Over the next several days, your child may develop some of the symptoms below. These may not all happen at the same time.

• Red, swollen hands and feet
• Red lips and mouth, including dry, cracked lips and a red tongue with bumps (strawberry tongue)
• Red, blotchy rash
• Swollen lymph nodes in the neck
• Red eyes without drainage or crusting
• Peeling skin on the hands or feet a
  few weeks after the fever starts

Other symptoms may include joint pain or swelling, stomach pain, diarrhea, vomiting, headache, cough, or runny nose.

How Is Kawasaki Disease Diagnosed?

There is no single test for Kawasaki disease. The doctor may check for Kawasaki disease if your child has:

• A fever lasting more than 4 days.
• At least 4 of the signs and symptoms listed above.

Tests used to diagnose Kawasaki disease include:

• Blood and urine (pee) tests to look for signs of inflammation and rule out other illnesses.
• An electrocardiogram (ECG or EKG) to check the heart’s rhythm.
• An echocardiogram (echo), an ultrasound that looks at the heart and blood vessels.

How Is Kawasaki Disease Treated?

Most children recover fully when treatment starts within 10 days of symptoms appearing. Treatment may include:

• Intravenous immunoglobulin (IVIG) given through an IV.
• Aspirin to lower fever and inflammation and help prevent blood clots.

What Can I Expect With Kawasaki Disease?

At Home

Your child may feel tired or irritable for a few weeks while recovering. The doctor or health care provider will tell you when they can return to normal activities and school or daycare.

The doctor or health care provider may tell you to:

• Check your child’s temperature each day for 3 days after going home.
• Give aspirin exactly as ordered. Give it with food or milk to help prevent stomach upset.
• Not give any other medicine until they say it’s safe.
• Encourage your child to drink plenty of fluids.
• Use petroleum jelly (Vaseline^®) on dry lips.
• Use unscented lotion or cream on dry skin.

Vaccines (Immunizations)

Talk with your child’s doctor or health care provider about vaccines after IVIG treatment. Your child should not get live vaccines, like MMR and chickenpox, for 11 months after treatment. However, if they’re taking aspirin during flu season, they should get a flu shot.

When Should I Call the Doctor?

Call your child’s doctor or health care provider if they:

• Have a fever of over 100.4°F (38°C).
• Get a rash again.
• Do not seem like themselves.
• Seem very tired or have little energy to play after the fever has gone away.
• Get the flu or chickenpox while taking aspirin.
• Have signs of taking too much aspirin, like:

Your child will have follow-up visits in the Kawasaki Disease Clinic for the first few months after leaving the hospital.

Heart tests are usually done about 2 weeks after treatment starts and again 6 to 8 weeks later. These visits help the doctor check your child’s heart and blood vessels. Some children may need more follow-up visits and testing.

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