Key takeaways: Kawasaki disease mostly affects children under 5. The main sign is fever lasting 5 or more days, along with symptoms like red eyes, rash, red cracked lips, swollen hands and feet, and swollen neck glands. Babies under 6 months may have fewer signs. Early treatment with IVIG lowers the risk of heart artery damage.
Kawasaki disease is uncommon, but it’s a leading cause of acquired heart disease in children in the U.S. Early diagnosis matters.
What It Is
Kawasaki disease causes inflammation of blood vessels throughout the body. It can affect the coronary arteries that supply the heart. The cause isn’t known, and it isn’t contagious.
Signs
Fever for 5 or more days, plus several of these:
- Red eyes without discharge.
- Rash on the body.
- Red, cracked lips and a red “strawberry” tongue.
- Swollen, red hands and feet, with peeling skin later.
- Swollen lymph node in the neck.
Children are often very irritable.
From the author
From First Breath to First Birthday is my month-by-month guide to your baby’s first year, written as a NICU and postpartum nurse. My book covers common first-year illnesses and the warning signs that mean it’s time to call the doctor, explained the way I’d explain them at the bedside.
Incomplete Kawasaki Disease
Babies, especially under 6 months, may have fever with only a few of these signs. They may also be at higher risk of heart complications. The American Heart Association has guidance for doctors to evaluate prolonged fever in young babies.
Diagnosis
There’s no single test. Doctors use symptoms, blood tests, and an echocardiogram (heart ultrasound).
Treatment
- IVIG (intravenous immune globulin), ideally within the first 10 days of fever, lowers the risk of coronary artery aneurysms.
- Aspirin under close medical supervision. This is one of the few times aspirin is used in children, and only as directed by doctors.
- Follow-up echocardiograms.
Call your baby’s doctor if your baby: has a fever lasting more than 3 days, or a fever with red eyes, rash, red lips, or swollen hands or feet. Any fever in a baby under 3 months needs a call right away.
The Bottom Line
Prolonged fever with red eyes, rash, red lips, or swollen hands and feet may be Kawasaki disease. Early treatment protects the heart.
Want more support for your baby’s first year? My book, From First Breath to First Birthday, is available on Amazon.
Related Articles
- Rashes With Fever: Which Ones Need Urgent Care
- Swollen Glands (Lymph Nodes) in Babies
- Measles: Why It’s So Dangerous for Babies
Sources
- McCrindle BW, Rowley AH, Newburger JW, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a scientific statement for health professionals from the American Heart Association. Circulation. 2017;135(17):e927-e999.
- American Heart Association. Kawasaki disease. https://www.heart.org
- Centers for Disease Control and Prevention. About Kawasaki disease. https://www.cdc.gov/kawasaki
This article is for general education and is not a substitute for individualized medical advice. Always talk with your baby’s health care provider or your own provider about your specific situation. If you think your baby or you may have a medical emergency, call 911.
