How to Recognize and Treat Kawasaki Disease
Kawasaki is a disease, primarily affecting children, that causes inflammation in the walls of medium arteries throughout the body. This can often be a frightening, severe disease that can last for several days, but it is usually treatable without serious complications. Start at step one to learn how to recognize and treat it.
Gaining Knowledge About the Disease
Realize the risk factors.Currently, there is no known scientific cause for this disease, but there are several factors which may increase the chances of getting it.
- Children under five are most at risk, particularly ages 1 to 2.
- It is not contagious in any way.
- Boys are more likely, only slightly, to develop the disease.
- Asians and Pacific Islanders have higher rates of this disease.
Recognize the symptoms and phases.There are three phases, each with their own symptoms.
- Phase one:
- Fever higher than 102.2 lasting longer than three days
- Extremely red eyes
- Rash on trunk of body and genitals
- Dry/cracked lips and swollen tongue
- Swelled skin on palms of hands and soles of feet
- Swollen lymph nodes in the neck
- Phase two:
- Peeling skin on hands and feet, often in large sheets
- Joint pain
- Abdominal pain
- Third phase:
- In this phase, symptoms typically start to fade. It can take up to eight weeks before energy levels return to normal.
- Phase one:
Know when to visit a doctor.If a fever lasts more than three days or if they have a fever and four or more of the above symptoms, visit or contact your medical provider. Early diagnosis and treatment can often prevent future heart problems.
Preparing for your Doctor's Appointment
Make note of everything your child is experiencing.Even if you don't think it's significant, write everything down and tell your doctor about it.
Bring a list of any medications your child is taking, even vitamins and supplements, over the counter medications, etc.
Ask someone to join you.In this stressful time, you might want to bring a friend or family member with you who can remember something you might forget either to tell the doctor or that the doctor tells you.
Prepare for any questions.It's impossible to guess exactly what your doctor will ask you, but these are some of the most common:
- When did the symptoms start?
- How severe are they?
- How high has the fever ever reached? How long did it last?
- Has your child been exposed to any diseases?
Diagnosing the Disease
Visit a trusted doctor.
Rule out other diseases.Although there is no specific test for the disease, the first step is ruling out other things that it could be. The list typically includes:
- Scarlet fever caused by bacteria that often results in fever, rash, and sore throat
- Rheumatoid Arthritis
- Stevens-Johnson syndrome
- Toxic shock syndrome
Prepare to get your child tested.There are several other tests after that will help narrow it down further:
- Urine test
- Blood tests
- Electrocardiogram (which uses electrodes attached to the skin to measure electrical impulses of the heartbeat)
- Echo cardiogram. This uses ultrasound images to show how the heart is functioning.
Treating the Disease
Get a Gamma globulin shot.This is given through a vein and can lower the risk of further problems with the artery.
Give child aspirin.High doses of this medicine help to treat inflammation, reduce pain and fever, and lower the risk of blood clots. This is a rare exception to the rule about giving children aspirin, and it's important to follow the doctor's rule exactly. Do not give aspirin to your child without talking to your doctor, and do not give them any more than what the doctor prescribes.
Stick to the plan.Even after the fever fades, your child might need to continue with low doses of aspirin for up to six weeks. Your child may be tired and fussy, and his or her skin may be dry for a month or so. Try not to let your child get overly tired. Use skin lotion to help keep the fingers and toes moist.
Monitor the heart.The doctor may recommend follow-up tests often 6-8 weeks after and again after six months, but if you notice any other problems, especially around the heart, take them back to the doctor for treatment and follow-up tests.
- It may take a few weeks before your child feels completely well. But most children who have Kawasaki disease get better and have no long-term problems. Early treatment is important because it shortens the illness and lowers the chances of heart problems. Follow-up tests can help you and your doctor ensure that the disease did not cause heart problems.
- Some children will have damage to their coronary arteries. An artery may get too large and form an aneurysm. Or the arteries may narrow or be at risk of blood clots. A child who has damaged coronary arteries may be more likely to have a heart attack as a young adult. If your child is affected, know what to watch for and when to seek care.
- Before your trip, write down questions you have to ask the doctor. This way you're not drawing a blank or scrambling during the visit.
- If your child develops the flu or chickenpox during treatment, it's important to contact your doctor. They may need to stop taking aspirin to prevent Reye's syndrome.
- With treatment, Kawasaki is usually fairly benign and your child may start to improve after the first Gamma Globulin treatment. Without treatment, it can last up to 12 days and may have lasting heart effects.
- Without treatment and sometimes with treatment (although very rare), possible heart effects that can occur are inflammation of the blood vessels that supply blood to the heart, inflammation of the heart muscles, heart valve problems, and aneurysms. It can even sometimes be fatal, although this is even rarer.
- Gamma globulin may affect the effectiveness of chickenpox and measles vaccines, so wait up to 11 months before getting a shot.
Video: "Developments in Diagnosis and Treatment of Kawasaki Disease" by Jane Newburger for OPENPediatrics
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