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Kawasaki Disease

What is Kawasaki disease?

Kawasaki disease is a rare childhood disease that causes swelling and irritation (inflammation) of the walls of blood vessels, especially heart arteries. With treatment, most children treated for Kawasaki disease recover completely. If this disease is not treated, it can cause some serious problems. For example, it can affect the coronary arteries, which are the blood vessels that bring oxygen and blood to the heart muscle. Changes in these blood vessels can cause blood clots and serious heart problems.

Kawasaki disease usually affects children between the ages of 6 months and 5 years.

What is the cause?

The cause of this disease is not known. The body's response to infection with bacteria or a virus, combined with genetic factors, may cause the disease. However, no specific bacteria or virus has been found as a definite cause.

The disease is more common in Asian countries, but there are also outbreaks in the US in late winter and spring every few years. Children in the same family are more likely to get Kawasaki disease. Children whose parents had the disease may have a more severe form of the disease.

The disease does not appear to be pass from one child to another. Your child won't get it from close contact with a child who has the disease.

What are the symptoms?

Symptoms may include:

  • Fever that stays high for more than 5 days
  • Rash
  • Swollen, dry, cracked lips
  • Red, swollen tongue
  • Red (bloodshot) eyes
  • Swollen lymph nodes in the neck
  • Swelling and redness of the hands and feet
  • Peeling of the skin on the hands and feet, especially around the tips of the fingers and toes, a few weeks after other symptoms start

Your child also may be irritable and have a sore throat, joint pain, diarrhea, vomiting, and stomach pain.

How is it diagnosed?

Your child's healthcare provider will ask about your child’s symptoms and medical history and examine your child. If your child has had a fever for many days and also has 4 or 5 of the other symptoms listed above, your provider will probably diagnose your child with Kawasaki disease. A diagnosis called atypical Kawasaki syndrome may be made if your child has a fever and fewer than 4 of the symptoms.

Tests may include:

  • An echocardiogram, which uses sound waves (ultrasound) to see how well the heart muscle is pumping
  • Blood tests
  • Urine tests
  • Chest X-ray
  • An ECG (also called an EKG), which measures and records the heartbeat

How is it treated?

Early treatment can usually prevent serious problems. Treatment is focused on lowering the fever and protecting the heart from damage. At first your child may need to stay in the hospital. Your child may be given high doses of aspirin to treat the inflammation and fever. Kawasaki disease is one of the few times when aspirin is used to treat children.

Then your child’s healthcare provider may prescribe long-term treatment with low doses of aspirin to help prevent blood clots.

Children and teens who get a viral infection, like the flu or chickenpox, while they are taking aspirin are at risk for a serious illness called Reye's syndrome. Your child may need to stop taking aspirin if he or she has a viral infection.

An IV medicine called immune globulin may be given to help protect your child’s arteries and heart.

If Kawasaki disease has affected your child's coronary arteries, your child will need ongoing care and treatment. Your child will need to be seen regularly by a pediatric heart specialist (cardiologist).

Most children who have Kawasaki disease usually recover within weeks of getting symptoms. It’s very rare for a child to get this disease more than once.

How can I take care of my child?

Follow your child’s healthcare provider's instructions.

Ask your provider:

  • How and when you will hear your child’s test results
  • How long it will take for your child to recover
  • If there are activities your child should avoid and when your child can return to normal activities
  • How to take care of your child at home
  • What symptoms or problems you should watch for and what to do if your child has them

Make sure you know when your child should come back for a checkup.

Written by Robert Brayden, MD, Clinical Professor of Pediatrics, University of Colorado School of Medicine.
Pediatric Advisor 2015.2 published by RelayHealth.
Last modified: 2015-03-01
Last reviewed: 2013-02-07
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
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