Kawasaki Disease: Cause, Symptoms, and Diagnosis

Kawasaki is a rare illness that affects small children. Other names for this disease are Kawasaki Syndrome and mucocutaneous lymph node syndrome. It is an inflammation in blood vessels which is a type of vasculitis. This disease is serious, but children can recover when treated right. It was first described in 1967 and named after Japanese pediatrician Tomisaku Kawasaki. The major cause of the disease is unknown. It may result from an excessive immune system response to an infection in predisposed children.

Symptoms of Kawasaki Disease:

Kawasaki’s major symptom is fever above 102 degrees Farenheit, which lasts for over 5 days. You can check the fever by using a forehead thermometer to know whether it is a normal fever or Kawasaki fever. The fever is incurable with normal medications like paracetamol or ibuprofen.

Other Kawasaki disease symptoms include:
  • Severe rashes occur in the diaper area.
  • Red, bloodshot eyes without pus, drainage, or crusting.
  • Swelling and tenderness of lymph node glands on the side of the neck.
  • Redness on the palms of the hands and the soles of the feet.
  • Swelling of hands and feet.
  • Very red, swollen, cracked lips, and Kawasaki disease strawberry tonguewith rough, red spots.
  • Irritability and fussiness.
  • Peeling fingers and toes typically happen 2 to 3 weeks after the beginning of the fever.

These symptoms may not be at the same time. In some infants, only a few of these will develop. Some non-specific symptoms includes vomiting, diarrhea, stomachache, cough, runny nose, headache.

Note: here are few best tips to cure diaper rashes
Some Facts You Should Know:
  • 80% to 90% of Kawasaki disease occurs in children under age 5 and older than 6 months.
  • Sex: Boys are 1.5 times more likely to get the disease than girls.
  • It is less common for older children and adolescents to get diagnosed with this disease, but in cases of exception, that is possible too.
  • It is not a contagious disease. Moreover, it does not spread among family members or children in care centers.
  • Kawasaki syndrome occurs mainly in Asian or Pacific Island regions.
  • Kids are more likely to get infected with this condition in the winter and spring season.

When do you need to call a doctor?

If your child is suffering from fever for over 4 to 5 days with any of the above key signs or symptoms, ask your doctor whether he or she has Kawasaki disease. It is challenging to diagnose, so your child must examine many times.

Diagnosis for Kawasaki disease

There is no specific test to diagnose the disease. If this syndrome is suspected, however, your doctor will order a few tests. First, your doctor will do a physical exam and ask about the child’s symptoms. They will mainly look for a long-lasting fever and a few signs, like red eyes, red lips and mouth, red, swollen limbs, rashes, and swollen lymph nodes. He/she would run some tests like blood and urine tests to check for other diseases and check for signs of inflammation. Mainly, they monitor heart function through electrocardiogram (EKG) and echocardiogram.

Also, perform imaging tests like X-rays and coronary angiograms. Besides these tests, your doctor may suggest you to a pediatric specialist in infectious disease, rheumatology, or cardiology for more guidance in diagnosis and treatment.

Treatment for Kawasaki disease

Children infected with Kawasaki disease are usually treated in hospitals. An intravenous (IV) dose is given through a vein over 8 to 12 hours. The child has to stay in the hospital for at least 24 hours after the IVIG dose to make sure the fever does not return.

They give aspirin to lower the risk of heart problems. IVIG show more impact when taken with aspirin. It reduces the heart issues when children took in the early stages of treatment.

There are five different types of drug therapy: a steroid preparation (prednisolone), aspirin, an antibiotic, a combination of steroids plus aspirin, and a combination of steroids plus warfarin.

Additional treatments are a must if a child does not respond well to the single dose of IVIG. So the child needs an another dose of IVIG or other medications like steroids, infliximab, or etanercept.

Treatment works in all conditions, if not doctor prescribe for other medicines to fight inflammation. If Kawasaki disease affects your child’s heart, he or she might need additional medicines, surgery, or other medical procedures.

Caution: Young children get treated with aspirin only under a doctor’s supervision because it causes a serious brain & liver condition known as Reye Syndrome.

Kawasaki Disease Complications

Kawasaki disease is a severe and scary disease because it involves the child’s heart. But many kids fully recover and have no lasting problems. In some 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 like weak or bulging artery walls known as aneurysms. Aneurysms raise a child’s risk of artery blockages, which leads to internal bleeding and heart attacks.

In severe cases, a child might need surgery infants to have a higher risk of serious complications. After the early symptoms go away, follow up with your child’s doctor to make sure their heart works normally. They need more X-rays, echocardiograms, EKGs, or other tests.

Precautions to be taken after discharge
  • The child is discharged from hospital with a low dose of aspirin to take by mouth every day for 6 to 8 weeks.
  • After recovering, it is common for children to be extra tired for several weeks and peeling of skin is expected.
  • Call your doctor immediately if your child develops a fever or any other symptoms of Kawasaki disease.We need further evaluation to determine if your child needs to admit to the hospital. Also, check for the development of coronary aneurysms.

So, from the above information, you may get a clear idea about the Kawasaki disease. It is most important to monitor your children after recovery to make sure they are improving.

Written by Jagannadh Ch