What are the key symptoms of Kawasaki disease?

Kawasaki disease is an illness that causes blood vessels to become inflamed, almost always in young children. It’s one of the leading causes of heart disease in kids. But doctors can treat it if they find it early. Most children recover without any problems.

The inflammation of Kawasaki disease can damage a child’s coronary arteries, which carry blood to their heart.

It can also cause problems with lymph nodes, skin, and the lining of a child’s mouth, nose, and throat.

Scientists haven’t found an exact cause for Kawasaki disease. It might be linked to genes, viruses, bacteria, and other things in the world around a child, such as chemicals and irritants.

The disease probably isn’t contagious, but it sometimes happens in clusters in a community. Kids are more likely to get it in the winter and spring.

Other things can raise a child’s risk of Kawasaki disease, including:

• Age. It usually affects children who are 5 or younger.
• Sex. Boys are 1.5 times more likely to get it than girls.
• Ethnicity. Children of Asian descent are more likely to have Kawasaki disease.

Kawasaki disease comes on fast, and symptoms show up in phases. Signs of the first phase of Kawasaki disease include:

• High fever (above 101 F) that lasts more than 5 days. It won’t go down even if a child takes medication that usually works on fever.
• Rash and/or peeling skin, often between the chest and legs and in the genital or groin area
• Swelling and redness in hands and bottoms of feet
• Red eyes
• Swollen glands, especially in the neck
• Irritated throat, mouth, and lips
• Swollen, bright red “strawberry tongue”

In the second phase, symptoms include:

Kawasaki disease can cause heart trouble 10 days to 2 weeks after symptoms start.

Symptoms tend to go away slowly in the third phase. It might last as long as 8 weeks.

Call your doctor if your child has these symptoms, including a fever between 101 and 103 F that lasts more than 4 days. Early treatment can help lower their risk of lasting effects.

Your doctor will do a physical exam and ask about your child’s symptoms. They’ll look for a long-lasting fever and at least four of these five signs:

• Red eyes
• Red lips and mouth
• Red, swollen limbs
• Rash
• Swollen lymph nodes

They may need to do tests to rule out other illnesses or to see whether the condition has affected your child’s heart. These include:

Your child may have a lot of pain from the fever, swelling, and skin problems. Their doctor might prescribe medication to make them feel better, such as aspirin and drugs that prevent blood clots. Don’t give your child any medication without talking to your doctor first.

The doctor will probably also give them immune globulin into a vein (intravenous, or IV). This has proteins called antibodies to help fight infection. It’s more effective when a child takes it with aspirin than aspirin is alone. It will lower a child’s risk of heart issues when they get it early on in treatment.

Most children start treatment for Kawasaki disease in a hospital because of a risk of complications.

Because it involves a child’s heart, this illness can be scary. But most kids recover completely and have no lasting problems.

In rare cases, children can have:

• Unusual heart rhythms (dysrhythmia)
• Inflamed heart muscles (myocarditis)
• Damaged heart valves (mitral regurgitation)
• Inflamed blood vessels (vasculitis)

These can lead to other troubles, including weak or bulging artery walls. These are called aneurysms. They could raise a child’s risk of artery blockages, which can cause internal bleeding and heart attacks. An echocardiogram can show many of these complications.

In severe cases, a child might need surgery. Infants have a higher risk of serious complications. In the U.S., fewer than 1% of children die during the early illness.

After the early symptoms go away, follow up with your child’s doctor to be sure their heart is working the way it should. They may need more X-rays, echocardiograms, EKGs, or other tests.