How is Kawasaki disease diagnosed?

Written by Shi Ji Peng
Pediatrics
Updated on December 22, 2024
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Kawasaki disease, also known as mucocutaneous lymph node syndrome, is an acute febrile rash disease characterized primarily by inflammation of medium and small arteries throughout the body, with a self-limiting nature. Clinically, it mainly presents with fever, rash, mucosal lesions, conjunctival congestion, and non-suppurative enlargement of cervical lymph nodes. If untreated, 20% of cases can lead to coronary artery damage. To diagnose this disease, in addition to typical clinical manifestations, attention must also be paid to various tests such as blood tests, immunological tests, and ultrasound examinations for a comprehensive assessment. Although the clinical characteristics are largely indicative of the disease, ultrasound examination is crucial to check for any dilation of the coronary arteries.

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Does Kawasaki disease cause a rash on the face?

The pathogenesis of Kawasaki disease is unclear, and the main pathological change is systemic vasculitis. Typically, the rash is a polymorphic erythema or a scarlatiniform rash, primarily occurring on the trunk. Generally, facial rashes are rare, but it's not entirely impossible for rashes to appear on the face. Therefore, if a baby develops a rash on the face without other infections, Kawasaki disease might also present this symptom.

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Is Kawasaki disease characterized by eye discharge?

Kawasaki disease is an autoimmune vasculitis that can affect blood vessels throughout the body and various organs, but the most severe impact is typically on the coronary arteries, which can lead to dilation of the coronary arteries or the possibility of forming coronary artery aneurysms. The disease can cause conjunctival congestion, but this is a manifestation of aseptic conjunctivitis, meaning it does not cause, nor does it result in, purulent secretions, in other words, it does not cause eye discharge. Therefore, if a patient with Kawasaki disease has purulent eye discharge, it is possible that they have a concurrent bacterial conjunctivitis. Thus, generally, eyes affected by Kawasaki disease do not have eye discharge but may appear dry and red.

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Kawasaki disease incubation period

Kawasaki disease, also known as mucocutaneous lymph node syndrome, is a common pediatric fever and rash illness, primarily a systemic small vessel vasculitis. Kawasaki disease is not contagious, so it has no incubation period; only infectious diseases have incubation periods. If it were contagious, typical manifestations would include persistent high fever, pinpoint appearances around the eyes and mouth, typical rash, swelling of the hands and feet, and non-purulent swelling of the cervical lymph nodes. Therefore, Kawasaki disease has no incubation period and is a vasculitis mediated by immune mechanisms.

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What is Kawasaki Disease?

Kawasaki disease was first reported in 1967 by Tomisaku Kawasaki in Japan and is also known as mucocutaneous lymph node syndrome. Approximately 15% to 20% of cases experience coronary artery damage after effective treatment. Since 1970, cases have been reported worldwide, with a higher incidence among Asians. As diagnostic capabilities improve globally, the incidence of this disease is decreasing. This disease occurs sporadically or in small epidemics and can occur in any season, most commonly affecting infants and young children, with 80% of cases occurring in children under five years of age. The cause of the disease is unclear, and the mechanism of onset is also not well understood, with the primary pathological change being systemic vasculitis. The main clinical symptoms are high fever between 39 to 40 degrees Celsius, followed by ineffectiveness of antibiotic treatment, and conjunctival congestion. Other symptoms include congested, cracked lips, diffuse congestion of the oral mucosa, indurative edema of hands and feet with emerging erythema, polymorphous skin eruptions and scarlet fever-like rash, and enlarged cervical lymph nodes, which can be unilateral or bilateral, hard and tender, but not red on the surface. There may be complications involving coronary artery damage, and potential complications such as myocarditis, pericarditis, endocarditis, and arrhythmias. Additionally, there may be other associated symptoms such as interstitial pneumonia, digestive system symptoms, joint pain, and arthritis.

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How long does it take to cure Kawasaki disease?

Kawasaki disease, also known as mucocutaneous lymph node syndrome, has unclear etiology and pathogenesis. The primary pathological change is systemic vasculitis, frequently affecting the coronary arteries. Kawasaki disease is considered a self-limiting condition, with most cases having a good prognosis; recurrence occurs in 1% to 2% of affected children. If associated with coronary artery damage and not effectively treated, 15% to 25% of these cases can develop coronary artery aneurysms. Typically, coronary artery aneurysms resolve within two years of onset, but often leave residual arterial wall thickening and reduced elasticity. Large aneurysms do not disappear completely and can lead to thrombosis or stenosis. Kawasaki disease is also one of the main causes of acquired heart disease in children. Therefore, active and effective treatment of Kawasaki disease can result in recovery. However, if there is accompanying coronary artery damage, the prognosis can vary depending on the extent of the damage. Severe coronary artery damage might lead to long-term heart disease.