Understanding the Symptoms of Kawasaki Disease in Children

Kawasaki disease is a condition that causes inflammation of the blood vessels. The coronary vessels that supply blood to the heart are particularly at risk.

Certain factors increase the chance of developing Kawasaki disease. It mainly affects children under age five and it's more common in boys than girls. Children who are of Asian or Pacific Islander descent have a higher risk of Kawasaki disease.

While the medical community doesn’t know why some kids are more at risk for Kawasaki disease, they do know it’s not spread from person to person, like other illnesses. Infections, your child’s genes, and certain environmental factors can affect your child's chances of getting Kawasaki disease.

Fever

One of the major symptoms of Kawasaki disease is a high fever. “It can last for five days and as long as two weeks,” says pediatric cardiologist Dr. Juan Alejos. It often starts with a fever of 102 F but can reach 104 F.

Rash

Children with Kawasaki disease can develop a rash during the initial stages, usually on the stomach, chest, and back. But it can spread over the entire body, according to Dr. Kimball, a pediatric cardiologist at Children’s Hospital New Orleans. “It consists of red flat areas, and isn’t itchy or blistery,” he adds.

Red Eyes

“Red eyes are another prominent feature,” says Dr. Kimball. There isn’t any pus or drainage, so healthcare providers can separate it from other common conditions that cause red eyes, such as pink eye.

Swollen Lymph Nodes

Kawasaki disease can cause swelling in the lymph nodes of the neck, which is why it’s also known as mucocutaneous lymph node syndrome. Some older children might only have a fever and swollen lymph nodes, which can lead healthcare providers to mistake the symptoms for a bacterial infection.

Changes in extremities

Your child might have red swollen hands and feet early on in the illness. Then, in later stages, this can change to peeling skin that starts on the fingers and toes. This peeling can spread to the hands and feet, says Dr. Kimball, “It looks like the peeling you get after a sunburn.”

“Strawberry tongue” is a term used to describe how the tongue can get red and irritated. You’ll see redness and bumps on your child’s tongue because of swollen taste buds.

Irritability

Children with Kawasaki disease might be irritable or fussy because of discomfort, especially early in the illness, according to Dr. Alejos.

“It’s out of proportion to the restlessness or irritability that accompanies other childhood illnesses such as the cold or flu. It’s unrelenting and children are inconsolable,” explains Dr. Kimball. Once treatment begins, that inconsolable fussiness goes away, and “it’s like they’re a different person.”

Joint Pain

Your child might experience pain and swelling in the joints. This symptom happens for about one in three children with Kawasaki disease. Most times, joint pain goes away, though some children can have it long-term. The pain most commonly affects the knees, hips, and ankles.

Gastrointestinal Symptoms

Your child might tell you their stomach hurts. They might also have vomiting and diarrhea. These common symptoms of Kawasaki disease can be distressing to your child.

Cardiac Complications

Dr. Alejos states that if Kawasaki disease is not treated, it can cause heart problems like coronary artery aneurysms or inflammation in the heart muscle, known as myocarditis. Up to 20 percent of kids can have complications with their coronary arteries or heart valves.

Kawasaki disease can be a scary diagnosis for your child. But Dr. Kimball says heart disease in children rarely happens, as long as treatment starts early. “A diagnosis of Kawasaki disease can’t be made until five days of [having] fever,” Dr. Kimball explains, “So, the window to treat is tight—between five and 10 days. If done in this manner, children usually do very well.”

Your child’s care team will focus on treating your child’s symptoms and preventing heart complications.

Treatment for Kawasaki disease includes aspirin to manage the fever, and giving an IV medication through your child’s veins called immunoglobulin (IVIG) antibodies. They will receive both medications in the hospital until the symptoms get better.

Follow-up care is an important part of managing your child’s health. Since Kawasaki disease can cause heart and blood vessel problems into adulthood, your child’s provider will want to see them for regular checks to make sure their heart stays healthy.

Experts

• Dr. Thomas Kimball, MD, pediatrician, and co-director of the Heart Center at Children’s Hospital New Orleans
• Dr. Juan Alejos, MD, pediatric cardiologist at UCLA