Kawasaki disease is an illness that causes the blood vessels in the body to swell and become inflamed. The exact cause of the illness is unknown, but it is not contagious.
It usually affects children younger than 5 years old, with the majority of them being less than 2 years old but it can affect older children as well.
It is prevalent among male children, and it is a very rare disease. In Nigeria alone, there are fewer than 10,000 cases a year.
Its symptoms often clear away on their own, and the affected child recovers, but without medical evaluation and treatment, serious complications may arise and may not be discovered promptly.
Diagnosis
There is no particular test to diagnose this illness.
Diagnosis is based solely on the child’s signs and symptoms. A prolonged fever, usually lasting more than 5 days and generally higher than 101.3F, is usually the first symptom to alert you.
The signs and symptoms that can help make this diagnosis include:
• Prolonged high fever that is lasting more than 5days.
• A nonspecific red rash that often involves the groin area and may feel
• Red eyes, or conjunctivitis without drainage
• Red lips and tongue
• Enlarged lymph nodes on one side of the neck
• Swollen and red hands and feet often followed by peeling of the skin
• Painful joints and irritability in younger children
• Enlargement of the gall bladder can cause abdominal pain and vomiting in some children
Other disease conditions may have these same symptoms.
To determine if a child has this illness, blood tests are carried out to identify;
• Recent strep or viral infection
• Body’s immune response
A urine sample can also be collected.
These laboratory tests are normally helpful, but the only specific way to confirm its diagnosis is by meeting the clinical criteria for most of the signs and symptoms listed above.
If your child meets the criteria for its diagnosis, the cardiology team is consulted.
Your child will have an electrocardiogram to assess the electrical system of the heart and an echocardiogram to identify the ultrasound of the heart.
Even if these results are normal, your child will still receive treatment based on the clinical symptoms and laboratory tests.
The effect of Kawasaki disease on the heart
The following complications can arise as a result of this illness on the heart;
• Coronary artery aneurysms, which is the most significant
• Leakage of the valves
• Build-up of fluid around the heart
This disease condition is the leading cause of acquired heart disease in children.
In as many as 25% of children with this illness, the heart becomes affected without proper treatment.
Treatment
Children with this illness are usually admitted to the hospital for 2-5days.
Treatment usually includes intravenous gamma globulin (IVIG), an infusion which is given intravenously and high-dose aspirin given every six hours.
These drugs help reduce the swelling and inflammation in the blood vessels. IVIG can decrease but not fully eliminate the risk of developing coronary aneurysms.
The infusion is most effective if administered within the first 10days of the illness and the risk of developing coronary aneurysms decreases from 25% to less than 5% when administered within the first 10days of the illness.
After discharge, your child is advised to continue taking the high-dose aspirin until the signs of inflammation and fever have cleared up.
Children are advised to take a low-dose aspirin every day for usually 6-8weeks or more and to be checked by a cardiologist even after the illness has been resolved.
Parents are usually concerned about using aspirin in children due to the concern over the association of aspirin use to Reye’s syndrome.
Reye’s syndrome is an inflammatory process that affects the brain and it has been associated with patients on long-term use of aspirin and have chicken pox or influenza.
Some doctors suggest that if your child is taking aspirin for a long period of time for any reason, they should take a flu shot to avoid being infected with influenza.
If your child is on a long-term use of aspirin and they have been exposed to or have chicken pox, you should contact your doctor immediately for medical advice.
What do you do after your child gets home?
It is very common for your child to feel irritable and tired for many weeks before getting back to normal.
Recovery often takes 6-8weeks or more.
You can do this for your child when at home:
• Check your child’s temperature each day for 3days after discharge
• Give your child aspirin as prescribed. Your child will have to take aspirin for at least 6weeks after getting home. Side effects like an upset stomach or a burning feeling in the stomach, associated with aspirin can be prevented by giving aspirin with food or a glass of milk.
• Do not give your child any other drugs without confirming with your pharmacist or doctor.
• Ensure your child gets enough fluids (at least 3 glasses a day).
• Treat dry lips with Vaseline and dry skin with unscented lotions or creams.
• Hold off on getting vaccines that use live viruses like the MMR and Varicella (chickenpox) for 11months after having the IVIG treatment. Prior to flu season, ensure your child receives the annual flu shot, especially if still taking aspirin.
• Moderate the activities your child engages in. Usually, more activities will be permitted after the first follow-up visit. At often times, your child maybe able to go back to school or daycare within a week after being discharged.
If your child has an aneurysm caused by this illness, he may have to visit the doctor more often but even with an aneurysm, the long-term outlook for your child is good.
As he gets older, it will be important that he eats healthy foods, exercise regularly and don’t smoke.
Dr. Favvy
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Disclaimer
The
information on this blog for educational purposes only.
It
should not be used as a substitute for the medical care and advise of your
pediatrician.
Always
consult your pharmacist before giving your child any drug.
Great one👍
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