Kawasaki Disease
Also known as Mucocutaneous lymph node syndrome
This article is general health information for the selected condition. It is not a diagnosis and does not replace clinical judgement. If you have questions or need treatment advice, please consult a qualified healthcare professional.
What is kawasaki disease?
Kawasaki disease is an acute inflammation of blood vessels that mainly affects children under five. Its importance lies in the risk of coronary artery aneurysms, which can be largely prevented if immunoglobulin treatment is given within the first ten days. Persistent unexplained fever of five days or more in a young child should prompt consideration of this diagnosis.
Causes
- Unknown, likely an abnormal immune response to an infectious trigger
- Genetic susceptibility
- Not spread from person to person
Symptoms
- Fever lasting five days or more
- Red eyes without discharge
- Red cracked lips and strawberry tongue
- Rash on the trunk
- Swollen red hands and feet
- Peeling skin of the fingers and toes in the second week
- Swollen lymph node in the neck, often one sided
- Marked irritability
Risk factors
- Age under 5 years
- Male sex
- Japanese or other East Asian ancestry
- Sibling or parent with previous Kawasaki disease
- Winter and early spring presentation
Diagnosis
- Clinical criteria of prolonged fever with characteristic features
- Raised inflammatory markers and platelet count
- Echocardiogram to assess the coronary arteries
- Exclusion of infections that can mimic it
- Recognition of incomplete forms, especially in infants
Treatment
- Intravenous immunoglobulin, ideally within ten days of fever onset
- Aspirin, initially at anti inflammatory then antiplatelet dose
- Corticosteroids or biologics for resistant disease
- Serial echocardiograms to monitor coronary arteries
- Long term cardiology follow up if aneurysms develop
Self care
- This is not a condition to manage at home; seek medical care
- Give prescribed aspirin exactly as directed, which is an exception to usual advice in children
- Attend all follow up echocardiograms
- Keep the child comfortable and well hydrated
- Delay live vaccines after immunoglobulin treatment as advised
When to see a doctor
Book an appointment if:
- Any child with fever lasting five days or more
- Fever with red eyes, rash and red cracked lips
- Peeling skin on fingers or toes after a febrile illness
- Irritability out of proportion to the illness
- Return of fever after treatment
- Concerns during cardiology follow up
Some symptoms need emergency care rather than an appointment. See the warning signs listed above.
Prevention
- Kawasaki disease cannot be prevented
- Coronary artery damage is largely preventable by treating within ten days
- Prompt assessment of prolonged unexplained fever in young children is the key step
Outlook
With immunoglobulin given within ten days of fever onset, most children recover completely and coronary aneurysm risk falls from around a quarter to under five percent. Children who develop aneurysms need long term cardiology follow up and sometimes lifelong antiplatelet or anticoagulant treatment.
Common questions
Why does timing of treatment matter so much?
Immunoglobulin given within the first ten days of fever reduces coronary aneurysm risk from around 25 percent to under 5 percent. Delay substantially increases the chance of permanent heart artery damage.
Is Kawasaki disease contagious?
No. It does not spread between children, so siblings and classmates are not at risk of catching it, although a genetic predisposition can run in families.
Do children recover completely?
Most recover fully, particularly with prompt treatment and normal coronary arteries. Children who develop aneurysms need long term cardiology follow up and sometimes ongoing antiplatelet or anticoagulant therapy.
References
Important: Dard AI is not a medical device and does not diagnose, treat, or replace clinician judgement. This article is general information only. Always consult a qualified healthcare professional about diagnosis and treatment, and seek emergency care for severe or rapidly worsening symptoms.