Clinical focus: a look at Kawasaki disease

What is it?

It is a disease of unknown origin, probably infectious but with autoimmune and genetic elements that affect children.

What does it look like?

The child will have a prolonged fever of at least five days. The most common classical features in addition to fever are:

• bilateral conjunctivitis
• anterior uveitis (inflammation of the iris of the eye)
• perianal erythema.

Other classic features are:

• redness and swelling on hands and feet
• red coloured tongue and lip fissures
• liver, kidney and GI dysfunction
• myocarditis and pericarditis
• swollen lymph glands, often just one cervical node.

Other symptoms are non-specific but include:

• irritability
• vomiting
• reduced eating and drinking
• cough
• diarrhoea
• runny nose
• weakness
• abdominal pain
• joint pain.

The fever can vary but can have spikes of 39-40˚C.

What should I do about it?

All children with a fever that has lasted five days or more, or those with a fever of shorter duration, who are displaying classical features, should see a doctor to rule out Kawasaki disease.

Kawasaki is a rare condition – the Trust has produced a ‘rare conditions handbook’ that covers this, and other rare illnesses, to help with your clinical decision making. You can download a copy here.