Kawasaki Disease: Signs, Symptoms and Diagnosis

What are the symptoms?

Kawasaki disease (KD) is diagnosed when a patient runs a fever of at least 100.4°F and above for at least five days. (If the fever isn’t treated, it can last up to 11 days.) The fever is accompanied by at least four of the following five symptoms:

  • A rash over the torso and extremities.
  • Redness and swelling of the palms and soles of the feet when the illness starts. Peeling of the skin on the fingertips and toes occurs in the second and third weeks. Larger pieces of skin can peel off the hands and feet as well.
  • Bloodshot eyes that can be sensitive to light.
  • Swollen lymph glands in the neck, usually on one side and measuring more than 1.5 centimeters. Sometimes the neck feels stiff.
  • Irritation and inflammation of the mouth, lips and throat. “Strawberry” tongue – the tongue is bumpy and red with enlarged taste buds.

Patients may experience abdominal pain. About one-third develop temporary arthritis with pain and swelling of knee, hip and ankle joints.

Incomplete Kawasaki disease should be considered if a child has fever and inflammation without all the symptoms above.

collage of symptoms of Kawasaki disease

Photos courtesy of Kawasaki Disease Foundation

What causes it and how can it be prevented?

We don’t know what causes KD. It is not spread from person to person. It’s also not hereditary. Rarely, more than one child in a family develops it, which may indicate a genetic predisposition.

There’s no known way to prevent KD. Parents should know that there’s nothing they could’ve done to prevent the disease.

How is KD diagnosed?

A health care professional must examine the child and observe the signs and symptoms. Blood and urine tests can also be run to rule out other illnesses and look for inflammation, but these tests are not specific for KD.

An echocardiogram, ultrasound of the heart, will provide a clear picture of the coronary arteries and how the heart is functioning. This may aid in making a diagnosis. The health care professional also may request other diagnostic tests.

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Last Reviewed: Jul 18, 2023