Diagnosis
There's no single test to find out whether your child has Kawasaki disease. Diagnosis involves ruling out other diseases that cause similar symptoms. These diseases include:
- Scarlet fever, an illness caused by bacteria that affects some people who have strep throat.
- Juvenile rheumatoid arthritis, the most common type of arthritis in children under the age of 16.
- Stevens-Johnson syndrome, a rare condition of the skin and mucous membranes.
- Toxic shock syndrome, a rare, life-threatening complication of some types of infections that are caused by bacteria.
- Measles, a disease caused by a virus that spreads easily through the air and settles on surfaces.
- Some illnesses caused by ticks, such as Rocky Mountain spotted fever.
A member of your child's healthcare team does an exam and orders blood and urine tests to help find the cause of the symptoms. 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 changes.
- Echocardiogram. This test uses sound waves to make pictures of the heart in motion. It helps healthcare professionals see how blood flows through the heart and heart valves. An echocardiogram shows how well the heart is working. It also can help find changes in the heart arteries.
More Information
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 the fever, reduce swelling and prevent heart damage.
Medication
Treatment for Kawasaki disease can include:
Gamma globulin. This protein is given through an IV. The treatment lowers inflammation in the blood vessels. It can lower the risk of problems with the heart arteries.
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 lessen pain, joint swelling and fever. The aspirin dose likely will be lowered once the fever has been gone for 48 hours.
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 there are issues with the heart arteries. Aspirin helps prevent blood clotting.
A child might start to improve soon after one gamma globulin treatment. Without treatment, the symptoms of Kawasaki disease last about 12 days. But heart complications might last longer.
Watching heart conditions
If your child has any signs of heart conditions, the healthcare professional might suggest follow-up tests to check your child's heart health. Often, tests are done within one week after diagnosis, again 6 to 8 weeks after the illness began, and then again after six months or a year depending on the damage to the heart arteries.
If heart issues last, your child might see a doctor called a pediatric cardiologist. This type of doctor treats heart disease in children. 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 help make choices about treatment with your child's healthcare team.
Most often, children who have been treated for Kawasaki disease get well within a few weeks and return to their usual activities. If your child's heart has been affected, talk with the pediatric cardiologist about whether you need to limit 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 and supplements your child takes, including doses.
- 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 make the symptoms better?
- What, if anything, seems to make the symptoms worse?
- Has your child been around people with infectious diseases?
- Does your child have allergies?