Signs parents may notice
- High fever lasting five days or more
- Red eyes without discharge
- Red, cracked lips or a red "strawberry" tongue
- A rash on the body
- Swollen, red hands and feet, with peeling skin of fingers and toes later
- A swollen gland on one side of the neck
- Unusual irritability, especially in infants
Tests that may be used
- Blood tests including CBC, ESR, CRP, liver tests and albumin
- Urine test
- Echocardiogram (heart ultrasound)
- ECG
What is Kawasaki disease?
Kawasaki disease is a condition in which blood vessels throughout the body become inflamed (vasculitis). It mainly affects children under five years of age, although older children can be affected too. The cause is not fully understood; it is thought to be an unusual immune response to a trigger in children who are susceptible.
The main concern in Kawasaki disease is its effect on the coronary arteries, which supply blood to the heart. Prompt treatment greatly lowers the chance of these arteries being affected, which is why recognising the condition early matters.
Signs to look for
Kawasaki disease usually begins with a high fever that lasts five days or more and does not respond well to fever medicines. Along with the fever, children usually develop several of the signs listed above. Not every child has every sign. Infants in particular may have only a few features, which is called incomplete Kawasaki disease, so doctors rely on blood tests and the heart scan as well.
How is Kawasaki disease diagnosed?
There is no single test for Kawasaki disease. The diagnosis is made from the pattern of symptoms and examination findings, supported by blood tests that show inflammation. An echocardiogram is done at diagnosis and repeated during follow-up to check the coronary arteries.
How is Kawasaki disease treated?
Kawasaki disease is treated in hospital.
- Intravenous immunoglobulin (IVIG) is the main treatment and works best when given early, ideally within the first ten days of fever.
- Aspirin is used to reduce inflammation and, later, in a low dose to protect the blood vessels.
- Additional treatment: some children continue to have fever after IVIG, or are at higher risk of heart involvement. They may need further treatment, such as steroids or a biological medicine called infliximab.
Most children improve quickly once treatment starts. Follow-up visits with repeat echocardiograms are usually arranged over the following weeks. Children with coronary artery changes need longer-term follow-up together with a pediatric cardiologist.
Kawasaki disease in infants
Kawasaki disease in babies can be harder to recognise because the classic signs may be incomplete. Infants may also have a higher chance of coronary artery involvement, so a low threshold for evaluation and early treatment is important.
Coming home
Children often feel tired for a few weeks after the illness, and peeling of the fingers and toes is common during recovery. While your child is on aspirin, let the doctor know if they are exposed to chickenpox or flu. Keep a record of the illness and the heart scan results for future reference.
Treatment options that may be considered
- Intravenous immunoglobulin (IVIG)
- Aspirin
- Additional treatment such as steroids or infliximab when needed
- Follow-up echocardiograms
When to seek medical help urgently
- Fever for several days with red eyes, rash, red lips or swollen hands and feet
- An infant with prolonged fever and unusual irritability
- Breathlessness, poor feeding, pale or cold skin, or a child who seems very unwell
Questions parents often ask
Is Kawasaki disease contagious?
No. It does not spread from child to child, and brothers or sisters do not need any special precautions.
Will my child's heart be affected?
Most children who are treated early recover fully without heart problems. A small number develop changes in the coronary arteries, the blood vessels that supply the heart. This is why echocardiograms are done during the illness and at follow-up visits.
Can Kawasaki disease come back?
It is uncommon for Kawasaki disease to happen again, but it can occur. If your child develops a similar illness in future, tell the doctor about the earlier episode.
Why are some vaccines delayed after treatment?
IVIG contains antibodies that can stop certain live vaccines, such as measles (MMR) and chickenpox vaccines, from working properly. These are usually postponed for several months after IVIG. Your doctor will advise on the exact timing.
Can my child play and go to school normally afterwards?
Most children return to normal activities once they recover. If the heart scan shows coronary artery changes, the doctor will advise on activity and longer follow-up.
This page is general information and not a substitute for a consultation. Every child is different, and the right treatment depends on an individual assessment. Please do not start, stop or change any medicine without speaking to your child's doctor.