How is Kawasaki disease treated?

Written by Yao Li Qin
Pediatrics
Updated on October 23, 2024
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Kawasaki disease, also known as mucocutaneous lymph node syndrome, can cause damage to the coronary arteries in untreated children, so it is crucial to treat the disease promptly once diagnosed. This disease generally occurs sporadically or in small outbreaks and can occur in any season, predominantly affecting infants and young children. The main treatment for Kawasaki disease is aspirin, which not only reduces fever but also helps reduce coronary artery lesions. Additionally, intravenous immunoglobulin is administered; however, the use of corticosteroids in Kawasaki disease is still somewhat controversial. Other treatments mainly include antiplatelet aggregation agents such as dipyridamole, and symptomatic supportive care for the child, including fluid supplementation, heart protection, control of heart failure, and correction of arrhythmias. For severe coronary artery lesions, coronary artery bypass surgery may be required. (Please use medication under the guidance of a professional physician.)

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Written by Yao Li Qin
Pediatrics
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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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Written by Li Jiao Yan
Neonatology
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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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Written by Yao Li Qin
Pediatrics
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Is Kawasaki disease prone to recurrence?

Kawasaki disease is a common pediatric febrile, rash-causing illness, and once diagnosed, treatment must begin actively. Most cases of Kawasaki disease have a very good prognosis with standard treatment, but about 5% of children may experience temporary coronary artery abnormalities, and the recurrence rate of Kawasaki disease can reach 1% to 3%. Therefore, once a child is diagnosed with Kawasaki disease, it is essential to conduct follow-up throughout the treatment process. Follow-ups should be done at three months, six months, and one year after the onset of the disease in new cases. The purpose of the follow-up is mainly to assess the child's prognosis and evaluate the coronary arteries to see if there is any recurrence, so this follow-up work is very important.

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Written by Li Jiao Yan
Neonatology
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How many days can Kawasaki disease be cured?

Kawasaki disease is a syndrome of mucocutaneous lymph node syndrome, the cause of which is unclear, as is the pathogenesis of the disease. The pathological changes are mainly systemic vasculitis, which is prone to secondary damage to the coronary arteries. It has a relatively long course. If fever occurs, the fever can persist for 1-2 weeks. Generally, special medications such as aspirin are required for treatment. Usually, treatment is for 3 days, and after the fever subsides, the dosage is gradually reduced, maintained for 6-8 weeks. If there is secondary coronary artery damage, the duration might be longer. In cases of severe coronary damage, the duration of the disease may be several months or even years, depending on the specific condition of the disease. Kawasaki disease is a self-limiting disease. Usually, if there is no significant coronary artery damage, after symptom control, comprehensive examinations are conducted 1 month, 3 months, 6 months, and 1-2 years after discharge, mainly heart examinations such as electrocardiograms and echocardiograms. If there is a combination of coronary artery aneurysms, long-term follow-up is required, with an examination every six months to one year until the coronary aneurysm disappears or if there is combined damage to the coronary artery structure, long-term follow-up is needed.

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Neonatology
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Does Kawasaki disease cause coughing?

Kawasaki disease has an unclear pathogenesis, primarily manifesting as systemic vasculitis, frequently affecting the coronary arteries. Clinically, it is characterized by fever, typically a high fever lasting seven to fourteen days, and is unresponsive to antibiotic treatment. Other symptoms include conjunctival congestion, cracked lips, diffuse oral congestion, and strawberry tongue. In the acute phase, there might be hard edema and erythema development, with polymorphous erythema and scarlatiniform rash typically on the trunk. Additionally, unilateral or bilateral cervical lymphadenopathy with tenderness can occur. Generally, coughing is rare and may be due to other infections like upper respiratory infections in children with weaker immunity.