Kawasaki disease is an illness that involves the skin, mouth, and lymph nodes, and most often affects kids under age 5. The cause is unknown, but if the symptoms are recognized early, kids with Kawasaki disease can fully recover within a few days. Untreated, it can lead to serious complications that can affect the heart.
Kawasaki disease occurs in 19 out of every 100,000 kids in the United States. It is most common among children of Japanese and Korean descent, but can affect all ethnic groups
Kawasaki disease can't be prevented, but usually has telltale symptoms and signs that appear in phases.
The first phase, which can last for up to 2 weeks, usually involves a persistent fever higher than 104° Fahrenheit (39° Celsius) and lasts for at least 5 days.
Other symptoms that typically develop include:
severe redness in the eyes
a rash on the stomach, chest, and genitals
red, dry, cracked lips
swollen tongue with a white coating and big red bumps
sore, irritated throat
swollen palms of the hands and soles of the feet with a purple-red color
swollen lymph nodes
During the second phase, which usually begins within 2 weeks of when the fever started, the skin on the hands and feet may begin to peel in large pieces. The child also may experience joint pain, diarrhea, vomiting, or abdominal pain. If your child shows any of these symptoms, call your doctor.
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What is the treatment for Kawasaki disease?
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Your doctor will want to begin initial treatment for Kawasaki disease as soon as possible after the appearance of signs and symptoms, preferably while your child still has a fever. The goals of initial treatment are to lower fever and inflammation and prevent heart damage.
To accomplish those goals, your child's doctor may recommend:
Aspirin. High doses of aspirin can reduce the fever, rash, joint inflammation and pain and help prevent blood clots from forming.
Gamma globulin. Infusion of gamma globulin (an immune protein) through a vein (intravenously) can lower the risk of coronary artery abnormalities.
Because of the risk of serious complications, initial treatment for Kawasaki disease usually is given in a hospital.
After the initial treatment
Once the fever subsides, your child may need to take low-dose aspirin for at least six to eight weeks, and longer if he or she develops a coronary artery aneurysm. Aspirin helps prevent clotting.
However, if your child develops flu or chickenpox during treatment, he or she will need to stop taking aspirin. Taking aspirin has been linked to Reye's syndrome, a rare but serious illness that can affect the blood, liver and brain of children and teenagers after a viral infection. (This is another reason to immunize your child on schedule against chickenpox.)
Without treatment, Kawasaki disease can last from two to 12 weeks. With treatment, your child may start to improve within 24 hours.
Monitoring heart problems
If your child has any indication of heart problems, your doctor may recommend follow-up tests to monitor heart health at regular intervals. If your child develops continuing heart abnormalities, your doctor may refer you to a doctor who specializes in treating heart disease in children (pediatric cardiologist). In some cases, a child with a coronary artery aneurysm may require:
Anticoagulant drugs. These medications, such as aspirin, warfarin and heparin, help prevent clots from forming.
Coronary artery angioplasty. This procedure opens arteries that have narrowed to the point that they impede blood flow to the heart.
Stent placement. This procedure involves implanting a device in the clogged artery to help prop it open and decrease the chance of re-blockage. Stent placement often accompanies angioplasty.
Coronary artery bypass graft. This operation involves rerouting the blood around a diseased coronary artery by grafting a section of blood vessel from the leg, chest or arm to use as the alternate route.
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