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When Your Child Has Kawasaki Disease

Kawasaki disease (KD) is a rare illness that happens in children. It is a type of vasculitis. Vasculitis means inflammation of the blood vessels. It can affect the whole body. The cause of KD is unknown. KD most often occurs in children under 6 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.

What Are the Signs of Kawasaki Disease?

The most common sign of KD is a fever. The fever is usually high (102°F [38.8°C] to 104°F [40°C]). It tends to rise and fall, but stays above 101.3°F (38.5°C). It usually doesn't get better even after taking a fever-reducing medicine. The fever usually lasts more than 5 days. To prevent complications, your child's doctor may make the diagnosis and start treatment before then. Other signs of KD include:

  • Rash

  • A swollen lymph node, usually in the cervical (neck) region

  • Swollen hands and feet

  • Red eyes

  • Red and dry cracked lips

  • Red tongue with white spots (called “strawberry tongue”)

  • Irritability

  • Fast heart rate

How Is Kawasaki Disease Diagnosed?

Boy lying on exam table. Health care provider is holding echocardiogram probe on skin of boy's chest. Woman is standing next to table.

Your child 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.

How Is Kawasaki Disease Treated?

  • 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.

    • Corticosteroids. These may be given if your child doesn't respond to immunoglobulin.

  • Your child is observed until symptoms improve. Once at home, low-dose aspirin may need to be taken for 6 to 8 weeks. Your child may need to take aspirin longer if the doctor is concerned about abnormal heart vessels.

After Leaving the Hospital

Call the doctor right away if your child has any of the following:

  • Symptoms that return or worsen

  • Shortness of breath

  • Chest pain

  • Your child acts very ill, is unusually sleepy, or is very irritable

  • Fever:

    • In an infant under 3 months old, a rectal temerature of 100.4°F (38°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

What Are the Long-term Concerns?

  • After treatment, your child’s health should improve. Some symptoms may not resolve for 2 to 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.

 

 
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