The nurse is caring for a child with Kawasaki disease who is receiving IV immunoglobulin
Kawasaki (Kah-wah-SOCK-ee) Disease, although rare, is the most common cause of acquired (not born with) heart disease in the United States and Japan. More than 80% of the children who get it are younger than 5 years of age. It is more common in boys and in Asians and Asian-Americans. Kawasaki Disease begins suddenly. The disease can cause blood vessels to become inflamed or swollen throughout the body. If untreated, the swelling can lead to damage of the blood vessel walls, especially those that go to the heart (coronary arteries). A section of a blood vessel wall can balloon out and become weak. This is called an aneurysm. Over time, the inflammation in the vessel goes away but the aneurysm stays. Aneurysms can cause serious problems later, most notably blood clots. When treatment begins within 10 days of the start of the disease, there is little risk of blood vessel and heart problems. It is not known what causes the disease. The immune system may be reacting to an unknown virus or there might be a genetic link in families. There is no way to prevent Kawasaki Disease. It is not contagious. It cannot be spread from one person to another. SymptomsThe first sign of Kawasaki Disease is a high fever (over 101°F, and often as high as 104°F) that lasts more than 4 days. Over the next several days (not all at once), these other key signs may occur:
Most children with Kawasaki Disease are also very irritable and fussy. However, not all children have all of these signs. Children may have a milder form, called “incomplete” (atypical) Kawasaki Disease. Both forms can cause damage to blood vessels if not treated right away. Other less common symptoms include:
DiagnosisThere is no single test to know if a child has Kawasaki Disease. The diagnosis is considered when the child has:
If Kawasaki Disease is suspected, the child will be hospitalized right away. In the hospital, the doctor may order tests to check the health of his or her heart.
TreatmentMost children fully recover without any damage to the blood vessels if treatment is started within 10 days. In the hospital, the child will be given:
After Your Child Goes HomeIt is common that a child will feel irritable and tired for many weeks before getting back to normal. Recovery often takes 6 to 8 weeks or more. The doctor will tell you:
When to Call the DoctorCall your child's doctor if you notice:
Follow-up AppointmentsYour child will need to come to the Kawasaki Disease Clinic regularly for the first few months. Usually, an ECG is ordered at 2 weeks and again at 6 to 8 weeks after treatment is started. The doctor will examine your child to make sure there are no heart problems. If your child has an aneurysm caused by Kawasaki Disease, the visits to the doctor may be more often. Even with an aneurysm, the long term outlook for your child is good. As he gets older, it will be important that he eat a healthy diet, exercise regularly and not smoke. Kawasaki Disease (PDF) HH-I-93 10/87, Revised 4/17 Copyright 1987 Nationwide Children’s Hospital |