Kawasaki Disease

Kawasaki disease is an illness that most commonly affects children of Asian descent under the age of four. The causes are mostly known, but it is clearly not contagious.

Kawasaki disease is characterized by a fever (typically 103°F) that rises and falls repeatedly for five or more days, followed by a cluster of at least four of the following symptoms:

  • Enlarged lymph nodes in the neck
  • Inflammation in and around the mouth – a rough, “strawberry” tongue, redness of the mouth and throat, and cracking and peeling of the lips
  • Swelling (edema) of the hands and feet, with peeling skits as the disease progresses
  • Redness of the membranes over the eyes, but without pus
  • A diffuse rash over the upper body and possibly the arms and legs

Fever may continue for 11 to 14 days, during or after which a number of heart abnormalities may develop. The most serious of these is damage to the coronary arteries, which supply blood to heart muscle. Coronary artery disease may occur in 20 to 25 percent of untreated cases, but prompt treatment can reduce the likelihood of this potentially serious complication.

Treatment of Kawasaki disease includes a single dose of intravenous gamma globulin and high doses of aspirin. Depending on the course of the illness, aspirin may be continued for a prolonged period of time. (This is one of the few situations in which aspirin is given to a small child with a fever. In viral illnesses such as chickenpox and influenza, aspirin is to be avoided because of the risk of Reye’s syndrome. Follow-up by a pediatric heart specialist is important until it is certain that no abnormalities of the heart are present.