Diagnosis
There's no single test to diagnose Kawasaki disease. Diagnosis involves ruling out other diseases that cause the same symptoms. These diseases include:
- Scarlet fever.
- Juvenile rheumatoid arthritis.
- Stevens-Johnson syndrome — a disorder of the mucous membranes.
- Toxic shock syndrome.
- Measles.
- Some illnesses caused by ticks, such as Rocky Mountain spotted fever.
A member of your child's healthcare team will do an exam and order blood and urine tests to help in the diagnosis. Tests might include:
- Blood tests. Blood tests help rule out other diseases and check blood cell count. A high white blood cell count, anemia and inflammation are signs of Kawasaki disease.
- Electrocardiogram (ECG or EKG). This quick test checks the heart's electrical activity. It shows how the heart is beating. Sticky patches called electrodes are attached to the chest and sometimes to the arms or legs. Wires connect the patches to a computer. The computer prints or displays results. An ECG can diagnose an irregular heartbeat. Kawasaki disease can cause heart rhythm problems.
- Echocardiogram. This test uses sound waves to make pictures of the heart in motion. It sees how blood flows through the heart and heart valves. An echocardiogram shows how well the heart is working. It also can help see problems with the heart arteries.
Treatment
It's best to start treatment for Kawasaki disease as early as possible, when your child still has a fever. Treatment for Kawasaki disease often happens in a hospital. The goals of treatment are to lower fever, reduce swelling and prevent heart damage.
Medication
Treatment for Kawasaki disease can include:
Gamma globulin. A protein called gamma globulin is given through a vein. This treatment lowers inflammation in the blood vessels. It can lower the risk of problems with the heart artery.
With treatment, a child might start to improve soon after one gamma globulin treatment. Without treatment, Kawasaki disease lasts about 12 days. However, heart complications might last longer.
After getting gamma globulin, wait at least 11 months to get a live vaccine, such as the chickenpox or measles vaccine. Gamma globulin can affect how well these vaccines work.
Aspirin. High doses of aspirin might help treat inflammation. Aspirin also can decrease pain, joint swelling and fever. The aspirin dose will likely be lowered once the fever has been gone for 48 hours.
For most other conditions, aspirin shouldn't be given to children. Aspirin has been linked to Reye's syndrome, a rare life-threatening condition, in children or teenagers who have the flu or chickenpox.
A healthcare professional needs to oversee giving aspirin to children with Kawasaki disease. Children who get flu or chickenpox during treatment might need to stop taking aspirin.
After the first treatment
Once the fever goes down, a child might need to take low-dose aspirin for at least six weeks. This can be longer if a there are problems with the heart artery. Aspirin helps prevent blood clotting.
With treatment, a child might start to improve soon after one gamma globulin treatment. Without treatment, Kawasaki disease lasts about 12 days. However, heart problems might last longer.
Watching heart problems
If your child has any signs of heart problems, the healthcare professional might suggest follow-up tests to check your child's heart health. Tests are often done 6 to 8 weeks after the illness began, and then again after six months.
If heart problems keep on, your child might be sent to a specialist who treats heart disease in children, called a pediatric cardiologist. Treatment for heart issues linked to Kawasaki disease depends on the type of heart condition.
Coping and support
Find out all you can about Kawasaki disease so that you can make good choices with your child's healthcare team about treatment.
Most often, children who have been treated for Kawasaki get well fast and return to their usual activities. If your child's heart has been affected, talk to the pediatric cardiologist about whether you need to restrict your child's activities.
Preparing for your appointment
You'll likely first see your family healthcare professional or pediatrician. Sometimes children with Kawasaki disease see doctors with special training in heart conditions, bone and joint disorders, or infectious diseases. A doctor who treats children with heart conditions is called a pediatric cardiologist. A rheumatologist treats children with bone and joint disorders.
Here's some information to help you get ready for your appointment.
What you can do
Bring someone with you to the appointment if you can. A family member or friend can take notes and help you remember all the information you're given.
Make a list of:
- Your child's symptoms, and when they began. Include any that don't seem linked to Kawasaki disease. Try to keep track of how high your child's fever has been and how long it has lasted.
- All medicines, vitamins or supplements your child takes, including doses.
- Write down questions to ask your child's healthcare professional.
For Kawasaki disease, some questions to ask include:
- What's the most likely cause of my child's symptoms?
- Are there any other possible causes for the symptoms?
- Does my child need tests?
- How long will the symptoms last?
- What treatments are there? Which do you suggest?
- How can I make my child more comfortable?
- Can you give me brochures or other printed information? What websites do you suggest?
Be sure to ask all the questions you have.
What to expect from your doctor
Your child's healthcare professional is likely to ask you questions, such as:
- How bad are the symptoms? How high has your child's fever been? How long did it last?
- What, if anything, seems to improve the symptoms?
- What, if anything, seems to worsen the symptoms?
- Has your child been around people with infectious diseases?
- Does your child have allergies?