Understanding Kawasaki Disease: Causes, Symptoms, and Treatment Options

Kawasaki disease is a rare illness that primarily affects young children, causing inflammation in their blood vessels. It is one of the leading causes of heart disease in kids, but with early detection and treatment, most children recover without any long-term problems.

Causes and Risk Factors

The exact cause of Kawasaki disease is unknown, but it may be linked to a combination of factors, including genes, viruses, bacteria, and environmental irritants. While the disease is not considered contagious, it sometimes occurs in clusters within a community. Children are more likely to develop Kawasaki disease if they:

• Are under 5 years old

• Are male (boys are 1.5 times more likely to get it than girls)

• Are of Asian or Pacific Island descent

Research also suggests that Black children with Kawasaki disease may experience more severe symptoms and respond differently to treatment compared to White children.

Symptoms of Kawasaki Disease

Kawasaki disease symptoms appear in phases and can include:

• High fever (above 101°F) lasting more than 5 days

• Rash, often between the chest and legs or in the genital area

• Peeling skin on fingers and toes (usually in the second or third week of illness)

• Swelling and redness in hands and feet

• Red eyes, swollen glands (especially in the neck), and irritated throat, mouth, and lips

• Swollen, bright red "strawberry tongue"

In the second phase, children may experience joint pain, belly pain, stomach issues (like diarrhea and vomiting), and peeling skin on their hands and feet. If you notice these symptoms in your child, particularly a fever between 101°F and 103°F that lasts more than 4 days, contact your doctor immediately, as early treatment is crucial.

Diagnosing Kawasaki Disease

To diagnose Kawasaki disease, your doctor will perform a physical exam, review your child's symptoms, and look for signs such as a persistent fever and at least four of the five main symptoms (red eyes, dry and cracked lips, rash, swollen lymph nodes, and swollen, discolored skin on palms and feet). They may also conduct tests to rule out other illnesses or check for heart involvement, including:

• Heart tests (electrocardiogram and echocardiogram)

• Blood tests

• Imaging tests (X-rays and coronary angiogram)

It's important to note that children with COVID-19 can develop a condition called multisystem inflammatory syndrome (MIS-C), which has symptoms similar to Kawasaki disease. Consult your child's doctor if you notice any concerning symptoms.

Treating Kawasaki Disease

Treatment for Kawasaki disease typically begins in a hospital setting due to the high risk of serious health problems. Your child's doctor may prescribe medication to alleviate pain and fever, such as aspirin and drugs that prevent blood clots. They will also likely administer immunoglobulin intravenously (IV) to help fight infection and reduce the risk of heart issues.

After the initial treatment, your child may need to continue taking low-dose aspirin for at least 6 weeks, especially if they develop a coronary artery aneurysm. Follow-up visits will be necessary to monitor for signs of heart problems, which may require additional tests and consultation with a heart disease specialist.

Complications and Outlook

While Kawasaki disease can be concerning due to its potential impact on a child's heart, most children recover completely without lasting issues. In rare cases, complications may include unusual heart rhythms, inflamed heart muscles, damaged heart valves, or inflamed blood vessels. These can lead to more serious problems, such as aneurysms, which increase the risk of artery blockages, internal bleeding, and heart attacks.

With proper treatment, the vast majority of children with Kawasaki disease can avoid heart disease and death. Only 6% of treated children develop coronary artery aneurysms, and 50% of those with coronary artery problems recover within 1-2 years with appropriate care. Without treatment, however, heart problems from Kawasaki disease can be fatal within 45 days of the onset of fever.

If you suspect your child may have Kawasaki disease, seek medical attention promptly to ensure the best possible outcome. For more information, consult the following reputable sources:

• Centers for Disease Control and Prevention (CDC)

• National Heart, Lung, and Blood Institute (NHLBI)

• American Academy of Pediatrics (AAP)

The Bottom Line

Immediate recognition and treatment within the first week of symptoms can prevent potentially fatal heart complications in over 95% of cases. Parents should seek emergency care for any child with prolonged fever plus multiple accompanying signs like rash, red eyes, or swollen extremities. If you're concerned about these symptoms in your child, Doctronic can provide rapid assessment and guidance on next steps.