Childen's Hospital Boston
International Visitorsdotted lineRequest Appointmentdotted lineDirections
 advanced search
About Us Find a Specialist Locations Careers Press Room Giving To
Clinical Services For Patients & Families For Health Professionals Research
My Child Has
or find by letter:  A-F  G-L  M-R  S-Z

Kawasaki Disease Program
Kawasaki Disease Program
About Kawasaki Disease
Who Kawasaki Disease Affects
Symptoms
Treatment
Conditions and Treatments
Second Opinions
Research
Meet the Team
Contact Us
Request an Appointment
Find Us
Email this page
Printer Friendly
Return to
Cardiovascular Program
X
Home Clinical Services Kawasaki Disease Program Symptoms
Flower Symptoms
Because Kawasaki disease can be so difficult to diagnose, Children's Hospital Boston keeps at least one Kawasaki Disease Program team member on call at all times to assist pediatricians and parents in determining the appropriate diagnosis and treatment.
How do I know if my child has Kawasaki disease?
A high fever -- lasting for at least four days -- is common to all cases of Kawasaki disease, and five additional symptoms point to the presence of the disease.

To meet the classic diagnostic criteria, a child must have at least four days of fever and four out of five of the diagnostic signs. It is possible to have Kawasaki disease without showing all of the diagnostic signs. Such cases are called atypical or incomplete Kawasaki disease.

Infants younger than 6 months are most likely to have atypical Kawasaki disease. They also have the highest risk for developing coronary artery damage. Therefore, pediatricians should consider treating a baby for Kawasaki disease whenever he or she has prolonged fever and any of the diagnostic criteria.

The five key symptoms
(in addition to persistent high fever):
hand Changes in extremities (usually occurs one to two weeks after onset of the illness): Reddening and rashes on palms and soles. Unexplained swelling of hands and feet peeling of the skin around fingernails and toenails
rash Rash, often accentuated in the groin area
blood shot red eys Bloodshot, red eyes, without drainage or pus
baby with red lips Redness in the lips, mouth and throat:
  • Reddening and cracking of the lips
  • A characteristic reddening of the tongue, called strawberry tongue
Swollen lymph nodes Swollen lymph nodes in the neck (more than 1.5 cm), usually just on one side
Photos 1 and 2 from Circulation. 2001;103:335. © 2001 American Heart Association, Inc. Used with permission.  
Other symptoms
Other symptoms that may be present include:
  • arthritis-like symptoms (joint pain and swelling of the joints)
  • unusual irritability
  • diarrhea
  • vomiting
  • abdominal pain
  • enlarged liver or gall bladder
Laboratory testing may show:
  • an elevated white blood cell count
  • anemia
  • signs of inflammation in the blood and urine
An echocardiography generally performed at the time of diagnosis to measure the coronary arteries and evaluate the function of the heart and heart valves.
Challenge of diagnosing Kawasaki disease
The challenge in diagnosing and treating Kawasaki disease is distinguishing it from several other childhood diseases with overlapping symptoms. The illnesses most commonly confused with Kawasaki disease are viral infections (such as measles, adenovirus, enterovirus and Epstein-Barr virus) and illnesses caused by bacterial toxins (such as scarlet fever, toxic shock syndrome or bacterial infection of lymph nodes in the neck).

Occasionally, Kawasaki disease can be confused with allergic reactions to medications or juvenile rheumatoid arthritis. Very rarely, Kawasaki disease is confused with Rocky Mountain Spotted Fever, mercury poisoning or leptospirosis.

Who should be treated for Kawasaki disease?
Then: In 1970, when the Japanese Ministry of Health first outlined guidelines for the diagnosis of Kawasaki disease, there was no effective treatment for the disease, nor any non-invasive way to assess cardiac complications. The main purpose of the initial guidelines was to accurately track the prevalence of the disease.

Now: Medicine has changed a lot in the past 35 years. Cardiologists can now use echocardiograms to get a picture of the arteries around the heart and there are effective approaches to treating Kawasaki disease and its complications.

Treatment should be given to all children with Kawasaki disease in the acute phase -- generally the first 10 days of illness. Treatment also should be given to those children beyond the 10th day of illness who continue to have fever without any other cause, or who have coronary artery enlargement or aneurysms, together with ongoing inflammatory changes measured in the blood.

X
Children's Hospital Boston is the primary pediatric teaching hospital of Harvard Medical School
Contact Us Site Map Privacy Accessibility Give Now en Español
Children's Hospital Boston300 Longwood AvenueBoston, MA 02115(617) 355-6000 © 2005-2007 All rights reserved