The skin rash of Kawasaki syndrome is usually erythematous. A 23-month-old Costa Rican boy was admitted with a clinical picture compatible with Kawasaki syndrome, except for his skin lesions. He had diffuse, confluent, multiple sterile whitish pustular lesions on his chest, abdomen, neck, genitals, and thighs
Kawasaki Disease
Kawasaki Disease is an illness that involves the skin, mouth, and lymph nodes, and typically affects children who are under the age of 5. The cause of Kawasaki Disease is unknown, but if the symptoms are recognized early, kids with the disease can fully recover within a few days. If it goes untreated, it can lead to serious complications that can involve the heart.
Kawasaki disease occurs in 19 out of every 100,000 kids in the United States. It is most common among children of Japanese and Korean descent, but the illness can affect all ethnic groups.
This illness can’t be prevented, but you can help your child by learning the telltale symptoms and signs, which typically include a fever that lasts for at least 5 days, red eyes, a body rash and severely-chapped lips and mouth. If your child shows these symptoms it’s a good idea to call the doctor.
Signs and Symptoms of Kawasaki Disease
The symptoms of Kawasaki Disease typically appear in phases.
The first phase, which can last for up to 2 weeks, usually involves a persistent fever that is higher than 104 degrees Fahrenheit (39 degrees Celsius), and lasts for at least 5 days. The other symptoms that typically develop include:
* severe redness in the eyes
* a rash on the child’s stomach, chest, and genitals
* red, dry, cracked lips
* swollen tongue with a white coating and big red bumps
* sore, irritated throat
* swollen palms of the hands and soles of the feet with a purple-red color
* swollen lymph nodes
During the second phase of the illness, which usually begins within two weeks of when the fever first begins, the skin on the child’s hands and feet may begin to peel in large pieces. The child may also experience joint pain, diarrhea, vomiting, or abdominal pain.
Complications of Kawasaki Disease
Doctors can manage the symptoms of Kawasaki disease if they catch it early. The symptoms typically disappear within just two days of when treatment begins. Usually, if Kawasaki disease is treated within 10 days of when the first symptoms begin, no heart problems develop.
But if the illness goes untreated (time period can vary, but likely for 10-14 days and sooner in young infants), it can lead to more serious complications that involve the child’s heart. Kawasaki disease can lead to vasculitis, which is an inflammation of the blood vessels. This can be particularly dangerous because it can affect the coronary arteries, which supply blood to the heart.
In addition to the coronary arteries, the heart muscle, lining, valves, or the outer membrane that surrounds the heart can become inflamed. Arrhythmias (changes in the normal pattern of the heartbeat) or abnormal functioning of some heart valves can also occur.
Diagnosing Kawasaki Disease
There is no one test to detect Kawasaki disease, so a doctor typically diagnoses it by evaluating the child’s symptoms and ruling out other conditions.
Typically, a child who is diagnosed with this illness will have a fever lasting 5 or more days and at least 4 of the following symptoms:
* redness in both eyes
* changes around the lips, tongue, or mouth
* changes in the fingers and toes, such as swelling, discoloration, or peeling
* a rash in the trunk or genital area
* a large swollen lymph node in the neck
* red, swollen palms of hands and soles of feet
If Kawasaki disease is suspected, a doctor may order tests to monitor the child’s heart function, which can include an echocardiogram, and other tests of heart function. A doctor may also take blood and urine samples to rule out other conditions, such as scarlet fever, measles, Rocky Mountain Spotted Fever, Stevens-Johnson syndrome, juvenile rheumatoid arthritis, and an allergic drug reaction.
Treating Kawasaki Disease
Treatment should begin as soon as possible, ideally within 10 days of when the fever first begins. Usually, a child is treated with intravenous doses of gamma globulin (purified antibodies), an ingredient of blood that helps the child’s body fight off infection. The child may also be given a high-dose of aspirin to reduce the risk of heart problems.
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