Kawasaki Disease | Diagnosis & Treatment

How is Kawasaki disease diagnosed?

There is no specific test for Kawasaki disease. One challenge in diagnosing Kawasaki disease is distinguishing it from other childhood diseases with similar symptoms.

To be diagnosed with classic Kawasaki disease, a child must have a high fever for at least five days, as well as four of the five classic symptoms.

It is possible to have Kawasaki disease without having all of the symptoms. Such cases are called incomplete or atypical Kawasaki disease. This is most common in infants younger than 6 months.

Are any tests needed to diagnose Kawasaki disease?

To arrive at a diagnosis, the doctor will start by taking a full medical history and conducting a thorough physical exam. 

Diagnostic tests may include:

How is Kawasaki disease treated?

The standard treatment for Kawasaki disease is IVIG (intravenous immunoglobulin). It is most effective in preventing long-term heart damage when started within 10 days of the onset of illness. IVIG can shorten the duration of the fever and decrease the risk of developing an abnormal enlargement of the coronary vein (aneurysm). Because IVIG is given intravenously (through a vein), your child will need to stay in the hospital during treatment and until his or her fever goes away.

Your child’s clinician may also recommend high doses of aspirin to control inflammation and fever.

Most children respond to their first treatment with IVIG. Some children continue to have a fever despite IVIG treatment, and may need additional treatment.

If your child develops coronary problems from Kawasaki disease, he or she may need to take blood-thinning (anticoagulant) medications — either on a short-term or lifelong basis — to reduce the risk of a clot in the coronary vein.

What is the long-term outlook?

Most children make a full recovery after Kawasaki disease, especially when diagnosed and treated early. Your child may be tired and irritable for a few weeks after he or she comes home and may not feel 100 percent better until six to eight weeks after the illness.

After having Kawasaki disease, the frequency of follow-up and types of testing will be based on your child’s specific needs. If your child never developed coronary artery enlargement, he or she will not need long-term follow-up by a cardiologist.

If your child developed an aneurysm from Kawasaki disease, he or she will need cardiology follow-up. Testing may include echocardiograms and other types of imaging.

Aneurysms may also occasionally occur in other arteries, such as those supplying the arms, legs or kidneys. These aneurysms rarely cause symptoms, and are generally seen only in patients who have giant coronary aneurysms.