Materiały źródłowe

• #1 Kawasaki Disease | AAFP

  https://www.aafp.org/pubs/afp/issues/1999/0601/p3093.html

  Kawasaki disease is a leading cause of acquired heart disease among children in the United States and other developed countries. Most children who contract this illness are less than two years old, and 80 percent of affected children are younger than five years of age. A generalized vasculitis of unknown etiology, Kawasaki disease can cause coronary artery abnormalities, including coronary aneurysms. From 20 to 25 percent of untreated children develop coronary artery abnormalities, which may resolve or persist. These abnormalities are of particular concern because they can lead to thrombosis, evolve into segmental stenosis or, rarely, rupture. The principal cause of death from Kawasaki disease is myocardial infarction. […] Based on findings in 50 Japanese children, Kawasaki described a unique illness that was characterized by fever, rash, conjunctival injection, cervical lymphadenitis, inflammation of the lips and oral cavity, and redness and swelling of the hands and feet.

• #1 Kawasaki Syndrome | Disease Outbreak Control Division

  https://health.hawaii.gov/docd/disease_listing/kawasaki-syndrome/

  Kawasaki syndrome typically occurs in three phases. […] Phase 1 (acute): Most patients develop high, spiking fever for about 10 days with four or more of the following symptoms: body rash, conjunctivitis, sore throat, swollen lymph nodes mostly in the neck, reddish discolorations on the palms of the hands and the soles of the feet, and red, dry, cracked lips and extremely red swollen tongue (strawberry tongue). This phase is the most intense and symptoms can be the most severe. […] Phase 2 (subacute phase): This phase begins as the fever and rash subsides with the tips of the fingers and toes begin to peel often. Patients may also develop joint pain, diarrhea, vomiting, and/or abdominal pain. This phase usually lasts about 2 weeks. […] Phase 3 (convalescent phase): Clinical symptoms gradually fade. Although KS is primarily self-limiting, the disease causes significant morbidity in most patients and can result in a range of cardiac and non-cardiac complications. Coronary artery abnormalities (CAA) can occur in more than 20% of untreated KS patients.1 For a small percentage of children who develop heart problems, KS is fatal even with treatment.

• #1 Kawasaki Disease – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/miscellaneous-disorders-in-infants-and-children/kawasaki-disease

  Kawasaki disease is a vasculitis, sometimes involving the coronary arteries, that tends to occur in infants and children between the ages of 1 year and 8 years. It is characterized by prolonged fever, exanthem, conjunctivitis, mucous membrane inflammation, and lymphadenopathy. […] The illness tends to progress in 3 phases: acute, subacute, and convalescent. […] The acute phase begins with fever lasting at least 5 days, usually 39 C (about 102.2 F) and unremittent when not treated with antipyretics. The fever is associated with irritability, occasional lethargy, or intermittent colicky abdominal pain. […] Within 5 days, a polymorphous, erythematous, macular rash appears, primarily over the trunk, often with accentuation in the perineal region. […] The acute phase ends with the resolution of fever.

• #1

  https://www.nhs.uk/conditions/kawasaki-disease/symptoms/

  The symptoms of Kawasaki disease usually develop in 3 phases over a 6-week period. […] Your child’s symptoms will appear suddenly and may be severe. Your child may be very irritable. […] The first and most common symptom of Kawasaki disease is usually a high temperature. […] The high temperature can come on quickly and doesn’t respond to antibiotics or medicines like ibuprofen or paracetamol. […] Your child’s high temperature will usually last for at least 5 days, but it can last for around 11 days without the proper treatment for Kawasaki disease. […] Rarely, the high temperature can last for as long as 3 to 4 weeks. […] Your child’s body temperature could possibly reach a high of 40C. […] Your child will almost always have a skin rash. […] Your childs hands and feet may swell up, and the skin on their hands and feet may become red or hard.

• #1 Recognizing Kawasaki disease

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2805967/

  Kawasaki disease (KD) occurs most often in children from one to three years of age. It is a common systemic vasculitis that is rare in children older than eight years of age or younger than six months of age; however, it may occur in these age groups. […] The acute phase of KD begins with the onset of fever, which usually ranges from 39C to 40.5C, and is unresponsive to antibiotics and, usually, to antipyretics. The other diagnostic criteria usually appear over the next two to five days and typically last 10 to 14 days without treatment. Oropharyngeal changes occur in almost all patients with typical disease and include bright red, cracked lips with generalized erythema of the oropharynx, including the buccal mucosa, and often a strawberry tongue. Approximately 90% of patients have a rash, which may have any appearance, but is rarely vesicular or pustular.

• #1 Frequently Asked Questions About KD | Rady Children’s Hospital

  https://www.rchsd.org/programs-services/kawasaki-disease-clinic/frequently-asked-questions/

  Fever and irritability often occur first. The fever has a rapid onset and fluctuates from moderate (101 to 104 F) to high (above 104). Lymph nodes in the neck may become swollen. […] A rash usually appears early in the illness; some patients may develop an accentuated rash in the groin. Often vivid red in appearance, the rash is composed of either poorly defined spots of various sizes or larger masses of merging spots. Fever continues to rise and fall, possibly for up to three weeks. Bloodshot eyes without discharge develop during the first week of illness. […] A child’s tongue may be red and show small, raised bumps (papillae); a condition called strawberry tongue because the enlarged papillae resemble the seeds on a strawberry’s surface. The lips become dry and cracked and often take on a bright red color. Mucous membranes of the mouth turn a darker red than usual.

• #1 Kawasaki disease – Wikipedia

  https://en.wikipedia.org/wiki/Kawasaki_disease

  If left untreated, some symptoms will eventually relent, but coronary artery aneurysms will not improve, resulting in a significant risk of death or disability due to myocardial infarction. […] The course of the disease can be divided into three clinical phases. The acute febrile phase, which usually lasts for one to two weeks, is characterized by fever, conjunctival injection, erythema of the oral mucosa, erythema and swelling of the hands and feet, rash, cervical adenopathy, aseptic meningitis, diarrhea, and hepatic dysfunction. […] The subacute phase begins when fever, rash, and lymphadenopathy resolve at about one to two weeks after the onset of fever, but irritability, anorexia, and conjunctival injection persist. […] The convalescent stage begins when all clinical signs of illness have disappeared, and continues until the sedimentation rate returns to normal, usually at six to eight weeks after the onset of illness.

• #1 Kawasaki disease – Wikipedia

  https://en.wikipedia.org/wiki/Kawasaki_disease

  Kawasaki disease also presents with a set of mouth symptoms, the most characteristic of which are a red tongue, swollen lips with vertical cracking, and bleeding. […] Cervical lymphadenopathy is seen in 50% to 75% of children, whereas the other features are estimated to occur in 90%, but sometimes it can be the dominant presenting symptom. […] In the acute phase of the disease, changes in the peripheral extremities can include erythema of the palms and soles, which is often striking with sharp demarcation and often accompanied by painful, brawny edema of the dorsa of the hands or feet, so affected children frequently refuse to hold objects in their hands or to bear weight on their feet. […] The most common skin manifestation is a diffuse macular-papular erythematous rash, which is quite nonspecific.

• #1 Kawasaki Disease: Signs, Symptoms and Diagnosis | American Heart Association

  https://www.heart.org/en/health-topics/kawasaki-disease/kawasaki-disease-signs-symptoms–diagnosis

  Kawasaki disease (KD) is diagnosed when a patient runs a fever of at least 100.4°F and above for at least five days. (If the fever isn’t treated, it can last up to 11 days.) The fever is accompanied by at least four of the following five symptoms: […] A rash over the torso and extremities. […] Redness and swelling of the palms and soles of the feet when the illness starts. Peeling of the skin on the fingertips and toes occurs in the second and third weeks. Larger pieces of skin can peel off the hands and feet as well. […] Bloodshot eyes that can be sensitive to light. […] Swollen lymph glands in the neck, usually on one side and measuring more than 1.5 centimeters. Sometimes the neck feels stiff. […] Irritation and inflammation of the mouth, lips and throat. “Strawberry” tongue – the tongue is bumpy and red with enlarged taste buds. […] Patients may experience abdominal pain. About one-third develop temporary arthritis with pain and swelling of knee, hip and ankle joints. […] Incomplete Kawasaki disease should be considered if a child has fever and inflammation without all the symptoms above.

• #1 Kawasaki disease (mucocutaneous lymph node syndrome)

  https://dermnetnz.org/topics/kawasaki-disease

  Typowo dziecko z chorobą Kawasaki ma wysoką, zmienną gorączkę (powyżej 39C), związaną z wieloma innymi cechami. 5 kardynalnych objawów choroby Kawasaki to: […] Dzieci z chorobą Kawasaki są często niezwykle drażliwe, w sposób nieproporcjonalny do innych objawów. Mogą również mieć szereg innych niespecyficznych objawów i znaków, w tym ból brzucha, biegunkę, dysurię (ból przy oddawaniu moczu), ból stawów lub zapalenie stawów, objawy zapalenia opon mózgowych lub niewydolności serca. […] IVIG znacznie zmniejsza ryzyko choroby wieńcowej, a niskodawkowa aspiryna zmniejsza ryzyko zakrzepów w obrębie tętnicy wieńcowej, jeśli rozwinie się choroba wieńcowa. Po leczeniu dzieci zazwyczaj szybko się poprawiają; większość objawów i oznak ostrej choroby ustępuje w ciągu 24 do 48 godzin, a gorączka ustępuje.

• #1 Kawasaki disease Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/kawasaki-disease

  Kawasaki disease often begins with a fever of 102°F (38.9°C) or higher that does not go away. The fever is often as high as 104°F (40°C). A fever lasting at least 5 days is a common sign of the disorder. The fever may last for up to 2 weeks. The fever often does not come down with normal doses of acetaminophen (Tylenol) or ibuprofen. […] Other symptoms often include: Bloodshot or red eyes (without pus or drainage), Bright red, chapped, or cracked lips, Red mucous membranes in the mouth, „Strawberry” tongue, with white coating on the tongue, or visible red bumps on the back of the tongue, Red, swollen palms of the hands and the soles of the feet, Skin rashes on the middle of the body, not blister-like, Peeling skin in the genital area, hands, and feet (mostly around the nails, palms, and soles), Swollen lymph nodes in the neck (often only one lymph node is swollen), Joint pain and swelling, often on both sides of the body. […] Additional symptoms may include: Irritability, Diarrhea, vomiting, and abdominal pain, Cough and runny nose.

• #1 Kawasaki Disease – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/miscellaneous-disorders-in-infants-and-children/kawasaki-disease

  The subacute phase lasts from the end of the fever until about day 25. […] Cardiac manifestations usually begin in the subacute phase of the syndrome about 1 to 4 weeks after onset as the rash, fever, and other early acute clinical symptoms begin to subside. […] The illness may last from 2 to 12 weeks or longer. […] Other less specific findings indicate involvement of many systems. […] The convalescent phase begins when clinical signs disappear and continues until about 6 to 8 weeks after the onset of the acute phase.

• #1 Kawasaki Disease (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/kawasaki.html

  Kawasaki disease is an illness that causes inflammation (swelling and redness) in blood vessels throughout the body. It happens in three phases, and a lasting fever usually is the first sign. […] The first phase, which can last for up to 2 weeks, usually involves a fever that lasts for at least 5 days. […] Other symptoms include: red („bloodshot”) eyes, a pink rash on the back, belly, arms, legs, and genital area, red, dry, cracked lips, a „strawberry” tongue (white coating with red bumps on the tongue), a sore throat, swollen palms of the hands and soles of the feet with a purple-red color, swollen lymph glands in the neck. […] The second phase usually begins 2 weeks after the fever started. Symptoms can include: peeling skin on the hands and feet, joint pain, diarrhea, vomiting, belly pain.

• #1 Kawasaki Disease Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/965367-clinical

  The subacute stage begins when the fevers have abated, and it continues until week 4-6. The hallmarks of this stage are desquamation of the digits, thrombocytosis (the platelet count may exceed 1 million/L), and the development of CAAs. The risk for sudden death is highest at this stage. 20-40% of patients experience arthralgia or arthritis during this period, both of which tend to favor the large weight-bearing joints. Other characteristics of the subacute stage are persistent irritability, anorexia, and conjunctival injection. […] The convalescent phase is marked by complete resolution of clinical signs of the illness, usually within 3 months of presentation. This stage begins with the return to baseline of the acute phase reactants and other laboratory abnormalities. Deep transverse grooves across the nails (Beau lines) may become apparent 1-2 months after the onset of fever. During the convalescent stage, cardiac abnormalities may still be apparent. Smaller CAAs tend to resolve on their own (60% of cases), but larger aneurysms may expand, and MI may occur. In patients whose echocardiograms were previously normal, however, detection of new aneurysms is unusual after week 8 of the illness.

• #1 Kawasaki Disease: Causes, Symptoms, and Treatment

  https://www.webmd.com/children/what-is-kawasaki-disease

  Kawasaki disease comes on fast, and symptoms show up in phases. Signs of the first phase of Kawasaki disease include: High fever (above 101 F) that lasts more than 5 days; it won’t go down even if a child takes medication that usually works on fever […] Rash, often between the chest and legs and in the genital or groin area […] Peeling skin on the fingers and toes (usually in weeks two or three of the illness) […] Swelling and redness in hands and bottoms of feet […] Red eyes […] Swollen glands, especially in the neck […] Irritated throat, mouth, and lips […] Swollen, bright red „strawberry tongue.” […] In the second phase, symptoms include: Joint pain […] Belly pain […] Stomach trouble, such as diarrhea and vomiting […] Peeling skin on hands and feet. […] Kawasaki disease can cause heart trouble 10 days to 2 weeks after symptoms start. Symptoms tend to go away slowly in the third phase. It might last as long as 8 weeks.

• #1 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Kawasaki-Disease-Symptoms.aspx

  Phase 2 refers to the period between weeks 2 and 4 when symptoms may still persist but have become less severe: Fever usually subsides but may persist as a low-grade fever. Skin on the palms of the hands and soles of the feet may peel. Vomiting and diarrhea along with abdominal cramps. Urine may contain white blood cells or pus. Lack of energy and drowsiness. Headache. Pain and swelling in the joints. Jaundice. […] Phase 3 is the recovery phase between the fourth and sixth week during which symptoms subside but the child lacks energy. Complications such as coronary artery vasculitis may develop during this phase or may still develop after a complete recovery.

• #1 What Is Kawasaki Disease? | Kawasaki Disease Foundation

  https://kdfoundation.org/what-is-kawasaki-disease/

  Kawasaki disease symptoms usually appear in three phases. Early symptoms of KD include: […] In the second phase of the disease, the symptoms may include: […] In the third phase of the disease, signs and symptoms will slowly fade away unless complications develop. Patients experiencing Kawasaki disease may experience tiredness, irritability and low energy for as long as eight weeks post the initial diagnosis.

• #1 Recognizing Kawasaki disease

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2805967/

  The subacute phase of KD begins when the fever resolves and lasts until symptoms and signs resolve usually between day 10 and 25 of the illness. It is at this time that characteristic desquamation of the skin at the fingertips and toes occurs. […] The convalescent phase of KD begins when all symptoms and signs resolve, and ends when the platelet count and ESR return to normal, usually 25 days to two months after the onset of fever.

• #1 Kawasaki disease – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/kawasaki-disease/symptoms-causes/syc-20354598

  Symptoms of Kawasaki disease include a fever greater than 102.2 degrees Fahrenheit (39 degrees Celsius) for five or more days. And the child has at least four of the following symptoms. […] Children with Kawasaki disease might have high fever, swollen hands and feet with skin peeling, and red eyes and tongue. […] The symptoms might not happen at the same time. Let your child’s healthcare professional know about a symptom that has gone away. […] Some children get a high fever for five or more days but have fewer than four of the symptoms needed for a diagnosis of Kawasaki disease. They might have what’s called incomplete Kawasaki disease. Children with incomplete Kawasaki disease are still at risk of damage to the heart arteries. They still need treatment within 10 days of when symptoms appear. […] Kawasaki disease can have symptoms like those of a condition called multisystem inflammatory syndrome in children. The syndrome happens in children with COVID-19.

• #1 Kawasaki disease – Wikipedia

  https://en.wikipedia.org/wiki/Kawasaki_disease

  Kawasaki disease often begins with a high and persistent fever that is not very responsive to normal treatment with paracetamol (acetaminophen) or ibuprofen. This is the most prominent symptom of Kawasaki disease, and is a characteristic sign that the disease is in its acute phase; the fever normally presents as a high (above 39-40 C) and remittent, and is followed by extreme irritability. […] The first day of fever is considered the first day of the illness, and its duration is typically one to two weeks; in the absence of treatment, it may extend for three to four weeks. Prolonged fever is associated with a higher incidence of cardiac involvement. […] Bilateral conjunctival inflammation has been reported to be the most common symptom after fever. It typically involves the bulbar conjunctivae, is not accompanied by suppuration, and is not painful.

• #1 About Kawasaki Disease | Kawasaki Disease | CDC

  https://www.cdc.gov/kawasaki/about/index.html

  Kawasaki disease (KD) can cause heart and blood vessel damage. […] KD symptoms include fever that lasts at least 5 days plus at least 1 other common disease symptom. […] Children with KD have a fever that typically lasts for 5 days or longer. They may also have some or all of the following symptoms: Rash, Swelling and redness of their hands and feet, Irritation and redness of the whites of their eyes, Swollen lymph glands in their neck, Irritation and inflammation of their mouth, lips, and throat. […] KD can cause serious complications, including swelling of parts of the heart and other blood vessels. When this happens, the heart doesn’t work as well to pump blood to the body and could burst (coronary artery dilation and aneurysms). […] Most children recover with proper treatment.

• #1 Kawasaki Disease: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/965367-overview

  Incomplete KD is diagnosed when a patient presents with fever for 5 days or longer, 2 or 3 of the principal clinical features, and laboratory findings suggestive of the disease or echocardiographic abnormalities. […] The principal goal of treatment is to prevent coronary artery disease. Intravenous immunoglobulin (IVIG), a purified preparation of gamma globulin, and aspirin are the mainstays of treatment. Patients should be treated with IVIG within 10 days after the onset of fever to prevent the development of cardiac sequelae. […] Approximately 20-25% of untreated patients develop cardiac sequelae, including CAAs. Aneurysms develop in 3-5% of patients treated with IVIG before the 10th day of illness. […] The most important predictor is total duration of fever longer than 8 days. Incomplete Kawasaki disease may also be an independent predictor of CAA development. […] The mortality from KD is low at less than 0.5%, with the highest risk in the first year after disease onset. Death is typically due to acute MI in the setting of giant aneurysms.

• #1 Kawasaki Disease in Children | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions—pediatrics/k/kawasaki-disease.html

  Kawasaki disease is a rare illness that most commonly affects children ages 0 to 5, but it can sometimes affect children up to the age of 13. […] The symptoms of Kawasaki disease can look like other health conditions. Make sure your child sees their healthcare provider for a diagnosis. […] These are common symptoms of Kawasaki disease: Fever of 102.0 F to 104.0 F (38.8C to 40.0C) that lasts for at least 5 days, Red rash, A swollen lymph node, usually in the neck, Swollen hands and feet, Red eyes, Red and dry cracked lips, Red tongue with white spots (called strawberry tongue), Irritability, Fast heart rate, Diarrhea or vomiting, Skin peeling. […] A fever for 5 days must be present in addition to having 4 out of 5 of the following symptoms: Red eyes, Changes in the lining of the mouth, Skin changes in the hands and feet, Rash, Swollen lymph nodes.

• #1 For Parents

  https://pediatrics.ucsd.edu/research/centers/kawasaki-disease/for-parents/index.html

  A child’s tongue may be red and show small, raised bumps (papillae); a condition called „strawberry tongue” because the enlarged papillae resemble the seeds on a strawberry’s surface. […] The palms of the hands and soles of the feet often turn bright red. Hands and feet can swell. […] When the fever subsides, the rash, red eyes and the swollen lymph nodes usually disappear. Skin starts to peel around the toenails and fingernails, often beginning during the third week of illness. […] Occasionally, joint pain and inflammation persist after other symptoms have disappeared. Transverse (horizontal) depressed lines on fingernails and toenails, which occur during the illness, may be visible for months afterward until the nails grow out.

• #1 Kawasaki Disease: Symptoms, Treatment, Complications

  https://patient.info/childrens-health/kawasaki-disease-leaflet

  Kawasaki disease causes a high temperature (fever), a rash, and other typical symptoms (listed below). […] A high temperature (fever) which lasts at least five days is usual. If your child has a fever for five days or more, you should see your doctor, who should assess them to see if they might have Kawasaki disease. In addition, at least four of the following normally develop: […] Bloodshot eyes […] Redness of the eyes (conjunctivitis) without sticky discharge. […] Changes in the mouth such as a red throat or tongue, or dry and cracked lips. […] A rash. This normally fades within a week. There is no specific 'Kawasaki rash’ – the appearance may be different in different children. Most often there are raised red blotchy areas. It tends to affect a lot of the body, particularly the chest, tummy, back, groins, hands and feet.

• #1 For Parents

  https://pediatrics.ucsd.edu/research/centers/kawasaki-disease/for-parents/index.html

  Kawasaki Disease is an unusual illness characterized by inflammation of blood vessels throughout the body. It is accompanied by the following symptoms: fever; rash; swelling of the hands and feet; irritation and reddening of the eyes; irritation and inflammation of the mucous membranes of the mouth, lips, and throat; and swollen lymph nodes in the neck. […] Fever and irritability often occur first. The fever has a rapid onset and fluctuates from moderate (101 to 104 F) to high (above 104). Lymph nodes in the neck may become swollen. […] A rash usually appears early in the illness; some patients may develop an accentuated rash in the groin. Often vivid red in appearance, the rash is composed of either poorly defined spots of various sizes or larger masses of merging spots. […] Eye inflammation (conjunctivitis), usually without discharge, develops during the first week of illness.

• #1 Kawasaki Disease in Children | Phoenix Children’s Hospital

  https://phoenixchildrens.org/specialties-conditions/kawasaki-disease-children

  Quick onset of high fever of 102.0 F to 104.0 F (38.8C to 40.0C) that lasts for at least 5 days […] Red rash […] A swollen lymph node, usually on one side of the neck […] Swollen hands and feet with redness (erythema) of the palms and soles […] Red eyes […] Red and dry cracked lips […] Redness and swelling of the mouth […] Red tongue with white spots (called strawberry tongue) […] Irritability […] Fast heart rate […] Abdominal pain, diarrhea, or vomiting […] Skin peeling […] Nail changes […] The symptoms of Kawasaki disease can look like other health conditions. Make sure your child sees their health care provider for a diagnosis. […] Kawasaki disease is diagnosed by having certain symptoms. For example, a fever lasting at least 5 days. […] A child with Kawasaki disease may have serious complications, especially ones affecting the heart.

• #1 Kawasaki Disease: Symptoms, Treatment, Complications

  https://patient.info/childrens-health/kawasaki-disease-leaflet

  Changes in the hands or feet such as mild swelling or redness. The skin on some of the fingers or toes often peels after about 2-3 weeks. […] One or more lymph glands in the neck become swollen. […] Children under 1 year old may not have as many other features of Kawasaki disease apart from fever. However, it is very important that they are checked out and referred for tests if the doctor thinks they may have Kawasaki disease. […] Typically, fever develops first and then the other symptoms (listed above) develop after a few days. Often, the symptoms that develop after the high temperature (fever) has started develop one after each other rather than all coming on at the same time. This is why the diagnosis may take several days to make after the initial fever starts. In total, symptoms tend to last up to 10 days before easing and going, although complications sometimes develop (see below). […] During the illness, some children become very unwell, but others have a mild illness. This may be similar to many common infections that are caused by a virus. However, any child suspected of having Kawasaki disease is normally admitted to hospital, even if they appear to have a mild illness.

• #1 Frequently Asked Questions About KD | Rady Children’s Hospital

  https://www.rchsd.org/programs-services/kawasaki-disease-clinic/frequently-asked-questions/

  The palms of the hands and soles of the feet often turn bright red. Hands and feet can swell. Occasionally, a child may develop a stiff neck. The child usually has great difficulty getting comfortable and remains irritable as a result of the multiple signs and symptoms. […] When the fever subsides, the rash, red eyes and the swollen lymph nodes usually disappear. Skin starts to peel around the toenails and fingernails, often beginning during the third week of illness. The skin on a hand or foot may peel off in large pieces or even a single piece (much as a snake sheds its skin). Knees, hips, and ankles can become painful and the child may have difficulty walking. […] Occasionally, joint pain and inflammation persist after other symptoms have disappeared. Transverse (horizontal) depressed lines on fingernails and toenails, which occur during the illness, may be visible for months afterward until the nails grow out.

• #1

  https://www.nhs.uk/conditions/kawasaki-disease/symptoms/

  Your child may feel their hands and feet are tender and painful to touch or put weight on, so they may be reluctant to walk or crawl while these symptoms persist. […] Conjunctival injection is where the whites of the eyes become red and swollen. […] Your child’s lips may be red, dry or cracked. They may also swell up and peel or bleed. […] The inside of your child’s mouth and throat may also be inflamed. […] Their tongue may be red, swollen and covered in small lumps. This is known as „strawberry tongue”. […] If you gently feel your child’s neck, you may be able to feel swollen lumps usually on one side. The lumps could be swollen lymph glands. […] During the sub-acute phase, your child’s symptoms will become less severe, but may last a while. […] The high temperature should subside, but your child may still be irritable and in considerable pain.

• #1

  https://www.nhs.uk/conditions/kawasaki-disease/symptoms/

  Symptoms during the second phase of Kawasaki disease may include abdominal pain, vomiting, diarrhoea, pee that contains pus, feeling drowsy and lacking energy (lethargic), headache, joint pain and swollen joints, yellowing of the skin and the whites of the eyes (jaundice), peeling skin on the hands and feet, and sometimes also on the palms of the hands or the soles of the feet. […] Your child will begin to recover during the third phase of Kawasaki disease, which is known as the convalescent phase. […] Their symptoms should begin to improve and all signs of the illness should eventually disappear. […] But your child may still have a lack of energy and tire easily during this time.

• #1 Kawasaki Disease: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/13457-kawasaki-disease

  Stage 2 (Subacute) Starts when fever goes away. Upset stomach. Diarrhea. Pain in joints and belly. Peeling skin on hands and feet. […] Stage 3 (Convalescent) Symptoms go away slowly, but complications can continue. […] Children can have Kawasaki disease symptoms for four to six weeks. They may feel tired and irritable for eight weeks. […] The outlook for children with Kawasaki disease depends on how much it affects their hearts. Complications that affect their heart can be severe enough to be fatal within 15 to 45 days of a fever starting. […] Coronary artery aneurysms can happen in 25% of people who don’t get treatment. In children who receive timely treatment, the rate of coronary artery aneurysms is less than 6%. With treatment, 50% of children with affected coronary arteries heal in one to two years. […] Yes. But with prompt treatment, most children with Kawasaki disease can recover completely.

• #1 Kawasaki Disease: Symptoms and Treatment | Doctor

  https://patient.info/doctor/kawasaki-disease-pro

  Other possible features include lethargy, urethritis, diarrhoea, vomiting, abdominal pain, myalgia, arthralgia and arthritis, along with other less common features listed in the 'Subsidiary features of the disease’ section below. […] Assess children with fever lasting five days or more for Kawasaki disease. […] Be aware that children aged under 1 year may present with fewer clinical features of Kawasaki disease in addition to fever, but may be at higher risk of coronary artery abnormalities than older children. […] The disease typically follows three phases, as outlined in the table below: […] Most (50-70%) coronary artery aneurysms regress after a period of 1-2 years, although giant aneurysms never resolve entirely and have a worse prognosis.

• #1 Kawasaki Disease Symptoms, Cause, Criteria, Treatment & Complications

  https://www.emedicinehealth.com/kawasaki_disease/article_em.htm

  Some patients, especially toddlers or older patients, may develop atypical or incomplete Kawasaki disease. Such a child will experience the persisting and prolonged fever but will not have the minimum of four characteristic clinical features described above. Diagnosis in these situations is much more difficult. Patients with atypical Kawasaki disease are actually more likely to develop coronary artery disease.

• #1

  https://www.beaumont.org/conditions/kawasaki-disease

  Kawasaki disease tends to have a very quick onset, but its symptoms occur in three phases acute, subacute, and convalescent. Children may experience heart trouble in as soon as 10 days after symptoms start, so its important to seek treatment right away. […] Symptoms include: Fever above 101F that doesnt respond well to fever reducing medications and lasts more than five days […] Heart rhythm irregularities […] Swollen, bright red tongue […] Kawasaki disease causes inflammation of the blood vessels, which can damage the coronary arteries. It also causes problems with the lymph nodes, skin, mouth, nose, and throat. […] About one-quarter of children who have Kawasaki disease may experience heart effects. It causes inflammation of and damage to the coronary arteries and the heart itself. When coronary arteries are weakened, an aneurysm may occur, which can be deadly. Infants are at greatest risk for heart complications, and they tend to become more seriously ill than older children who develop the disease.

• #1 Kawasaki Disease | AAFP

  https://www.aafp.org/pubs/afp/issues/1999/0601/p3093.html

  It is now known that coronary artery abnormalities develop in approximately 20 to 25 percent of children with untreated Kawasaki disease. […] The course of Kawasaki disease can be divided into three clinical phases: acute, subacute and convalescent. The acute febrile phase usually lasts seven to 14 days. This phase, which ends with the resolution of fever, is characterized by conjunctival injection, mouth and lip changes, swelling and erythema of the hands and feet, rash and cervical lymphadenopathy. The subacute phase covers the period from the end of the fever to about day 25. During this phase, patients may have desquamation of the fingers and toes, arthritis and arthralgia, and thrombocytosis. The convalescent phase begins when clinical signs disappear and continues until the erythrocyte sedimentation rate becomes normal, usually six to eight weeks after the onset of illness.

• #1 Kawasaki Disease | Symptoms, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/k/kawasaki

  Kawasaki disease can affect the heart by causing the following complications: Coronary artery aneurysms (or ballooning of the arteries), Leakage of valves (often mitral valve regurgitation), Build-up of fluid around the heart (pericardial effusion). Kawasaki disease is the leading cause of acquired heart disease in children. In as many as 25% of children with Kawasaki disease, the heart becomes affected without proper treatment. Aneurysms of the coronary arteries, the blood vessels that supply oxygen to the heart itself, are the most important complication of Kawasaki disease. With appropriate and timely treatment, the risk of coronary artery involvement decreases to around 5%. […] If a coronary aneurysm develops, the presence of long-term coronary artery changes depends on the size of the aneurysm the coronary artery changes can resolve, remain unchanged, or progress. Patients with large aneurysms are at risk for developing coronary artery clots or stenosis (narrowing) as the aneurysms heal.

• #1 Kawasaki Disease: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/965367-overview

  Kawasaki disease (KD), also known as mucocutaneous lymph node syndrome and Kawasaki syndrome, is an acute febrile illness of early childhood characterized by vasculitis of the medium-sized arteries. Given its predilection for the coronary arteries, there is a potential for the development of coronary artery aneurysms (CAAs) and thus sudden death. CAAs develop in approximately 25% of untreated cases; appropriate treatment decreases this risk to 3-5%. Echocardiography is the study of choice to evaluate for CAAs. KD is the leading cause of acquired heart disease in developed nations. […] Diagnosis of complete KD requires fever of at least 5 days’ duration along with 4 or 5 of the principal clinical features. The principal clinical features are as follows: Extremity changes, Polymorphous rash, Oropharyngeal changes, Bilateral, nonexudative, limbic sparing, painless bulbar conjunctival injection, Acute unilateral nonpurulent cervical lymphadenopathy with lymph node diameter greater than 1.5 cm.

• #1 Kawasaki Disease | AAFP

  https://www.aafp.org/pubs/afp/issues/1999/0601/p3093.html

  Coronary artery abnormalities develop in 20 to 25 percent of children with untreated Kawasaki disease. Abnormalities may include diffuse ectasia or coronary aneurysms. Patients who have giant aneurysms (maximum internal diameter of at least 8 mm) have the worst prognosis and are at greatest risk of developing coronary thrombosis, stenosis or myocardial infarction. […] If not treated within the first 10 days of illness, patients with Kawasaki disease who are younger than one year (especially those younger than eight months) have a substantially increased risk of developing coronary artery aneurysms. […] Myocardial infarction is the principal cause of death in patients with Kawasaki disease. Although infarction may occur during the acute phase of the disease, it more commonly occurs a year or even years later, especially in patients with giant aneurysms. Symptoms of myocardial infarction include inconsolable crying, vomiting, dyspnea, cardiovascular collapse and shock. Most documented cases of infarction have occurred during sleep or at rest.

• #1 Kawasaki Disease in Children | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions—pediatrics/k/kawasaki-disease.html

  Most children with Kawasaki disease get better within a few weeks. But serious complications may occur. Those involving the heart include: Weakening of one of the heart’s arteries (coronary artery aneurysm), Heart muscle that doesn’t work well or heart attack, Inflammation of the heart muscle (myocarditis), lining of the heart (endocarditis), or covering of the heart (pericarditis), Heart valves that don’t work well, Heart failure. […] There is a risk for early coronary artery disease after having Kawasaki disease, including early heart attacks. Your child will need to follow a heart-healthy lifestyle for life.

• #1 Kawasaki disease | Great Ormond Street Hospital

  https://www.gosh.nhs.uk/conditions-and-treatments/conditions-we-treat/kawasaki-disease/

  Kawasaki disease is a disease that causes swelling of the blood vessels throughout the body. It causes a high fever and rash. The symptoms of Kawasaki disease are like a lot of other more common childhood illnesses. The symptoms can come and go over a period of days and weeks, with new ones appearing. Initial signs can include: feeling unwell, fever (high temperature) over 38C for five days or longer, swollen lymph nodes (glands in the neck), rash (especially on the chest), palms of the hands and soles of the feet turn bright red, become puffy and the skin can peel, bloodshot eyes, redness on the inside of the lips and tongue and inside the mouth. […] Some children can have painful joints, tummy ache, diarrhoea and vomiting as well. For some children, the heart can be affected too. Around 20 to 40 per cent of children with Kawasaki disease develop problems in the blood vessels in the heart muscle. A bulge can develop in the wall of a heart blood vessel (coronary aneurysm). This can make it more likely for a blood clot to develop inside the vessel or it may become narrower as it heals. The valves inside the heart can also become leaky, so blood can flow backwards (regurgitation). The bag or sac that surrounds the heart can also fill up with fluid, putting pressure on the heart (pericardial effusion). These heart problems can lead to symptoms like breathlessness and chest pain.

• #1

  https://www.nuhs.edu.sg/patient-care/find-a-condition/kawasaki-disease-children

  The symptoms typically disappear within two days after the start of treatment. Usually, if Kawasaki Disease is treated within 10 days of when the first symptoms begin, no heart problems will develop. However, if the illness goes untreated (time period can vary, but likely for more than 12 to 14 days), it can lead to more serious complications that involve the child’s heart. Kawasaki Disease can lead to inflammation of the blood vessels. This can be particularly dangerous because it can affect the coronary arteries, which supply blood to the heart.

• #1 Kawasaki Disease in Children | University Hospitals

  https://www.uhhospitals.org/health-information/health-and-wellness-library/article/diseases-and-conditions—pediatrics/kawasaki-disease

  To diagnose Kawasaki, other causes for the symptoms must be ruled out. A fever for 5 days must be present in addition to having 4 out of 5 of the following symptoms: Red eyes, Changes in the lining of the mouth, Skin changes in the hands and feet, Rash, Swollen lymph nodes. […] Most children with Kawasaki disease get better within a few weeks. But serious complications may occur. Those involving the heart include: Weakening of one of the heart’s arteries (coronary artery aneurysm), Heart muscle that doesn’t work well or heart attack, Inflammation of the heart muscle (myocarditis), lining of the heart (endocarditis), or covering of the heart (pericarditis), Heart valves that don’t work well, Heart failure. […] There is a risk for early coronary artery disease after having Kawasaki disease, including early heart attacks. Your child will need to follow a heart-healthy lifestyle for life.

• #1 Kawasaki disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/kawasaki-disease/diagnosis-treatment/drc-20354603

  There’s no single test to diagnose Kawasaki disease. Diagnosis involves ruling out other diseases that cause the same symptoms. A high white blood cell count, anemia and inflammation are signs of Kawasaki disease. Kawasaki disease can cause heart rhythm problems. It’s best to start treatment for Kawasaki disease as early as possible, when your child still has a fever. The goals of treatment are to lower fever, reduce swelling and prevent heart damage. With treatment, a child might start to improve soon after one gamma globulin treatment. Without treatment, Kawasaki disease lasts about 12 days. However, heart complications might last longer. Once the fever goes down, a child might need to take low-dose aspirin for at least six weeks. This can be longer if there are problems with the heart artery. If your child has any signs of heart problems, the healthcare professional might suggest follow-up tests to check your child’s heart health. Tests are often done 6 to 8 weeks after the illness began, and then again after six months. If heart problems keep on, your child might be sent to a specialist who treats heart disease in children, called a pediatric cardiologist. […] Most often, children who have been treated for Kawasaki get well fast and return to their usual activities. If your child’s heart has been affected, talk to the pediatric cardiologist about whether you need to restrict your child’s activities.

• #1 Kawasaki Disease Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/965367-clinical

  Most children with KD are brought to medical attention because of prolonged fever. There are two forms of KD: complete and incomplete. Diagnosis of complete KD requires fever of at least 5 days’ duration along with 4 or 5 of the principal clinical features. The most recent version of the AHA guidelines suggest that if a patient presents with 4 or more of the principal criteria, KD can be diagnosed on day 4 of fever. Experienced clinicians who have treated many KD patients may establish diagnosis before day 4, and patients who present with coronary artery disease can be diagnosed if they have at least 3 of the 5 major diagnostic criteria. The principal clinical features are as follows: […] The acute stage begins with an abrupt onset of fever and lasts approximately 7-14 days. The fever is typically high-spiking and remittent, with peak temperatures ranging from 102-104F (39-40C) or higher. This fever is not responsive to antibiotics and can persist for up to 3-4 weeks if untreated. With appropriate therapy with IVIG, the fever typically remits within 36 hours.

• #1 Kawasaki disease

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4323050/

  The symptoms of KD can be classified into two categories, principal symptoms and other significant symptoms or findings. For diagnosis of KD, at least five items of 1-6 should be satisfied. However, patients with four items of the principal symptoms can be diagnosed as KD when coronary artery aneurysms or dilatation is recognized by two dimensional echocardiography or coronary angiography. […] The most important clinical problem in KD is cardiovascular lesions, which may cause sudden death or develop into coronary artery disease. […] In the early phase of the illness, pericarditis, myocarditis, endocarditis and coronary arteritis are present and exhibit mild to severe manifestations in most KD patients. […] If KD can be diagnosed within 1 week of onset and if IVGG treatment can be started early, coronary artery changes would be prevented in less than 5% of all patients. There are still 10-15% of cases resisting IVGG in the lowering of fever and need retreatment. However, giant aneurysms in a few patients (0.4%) have developed despite the fact that IVGG treatment was started within 7 days of onset. If diagnosis is delayed until 10 or more days after onset, the risk of coronary artery changes rapidly increases.

• #1 Kawasaki Disease | Symptoms, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/k/kawasaki

  Treatment includes intravenous gamma globulin (IVIG), which is an infusion through your child’s IV and high-dose aspirin every six hours. These medicines help reduce the swelling and inflammation in the blood vessels. IVIG can decrease, but NOT eliminate, the risk of developing coronary aneurysms. The infusion is most effective if given within the first 10 days of the illness, decreasing the risk of developing coronary changes from 25% to less than 5%. […] If after one year from the diagnosis of Kawasaki disease there is no heart involvement, your child’s cardiology visits are spaced out to annual visits or even every few years. Patients that have coronary aneurysms require periodic cardiology evaluations. The frequency of these visits varies depending on the extent of coronary changes. Often these visits are scheduled once every six to 12 months. With the right medical care, these patients also generally have a good prognosis.

• #1 Kawasaki Disease in Children | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/kawasaki-disease

  Kawasaki disease is an acute childhood illness that causes inflammation of the blood vessels in many areas of the body. If not treated early, it can cause damage to the coronary arteries, which supply the heart with oxygen. […] The symptoms of Kawasaki disease usually appear in phases, and can change or evolve over time. Symptoms of classic Kawasaki disease include: High fever, Rash, Redness or swelling of the hands, followed by peeling skin on the fingers or toes, Bloodshot eyes (both eyes), without drainage, Red, cracked lips, Strawberry tongue (a red, swollen tongue), Enlarged lymph node in the neck. […] Most children make a full recovery after Kawasaki disease, especially when diagnosed and treated early. Your child may be tired and irritable for a few weeks after they come home and may not feel 100 percent better until six to eight weeks after the illness.

• #2

  https://www.healthychildren.org/English/health-issues/conditions/heart/Pages/Kawasaki-Disease.aspx

  Kawasaki disease is the leading cause of acquired heart disease in infants and young children in the United States. More than 4,200 U.S. children are diagnosed with Kawasaki disease each year. […] The condition causes inflammation in the blood vessels, and the symptoms can be severe. In addition to several days of fever, children with Kawasaki disease may develop symptoms such as rash, swollen neck glands, swollen hands and feet, and red eyes, lips and tongue. […] Kawasaki Disease begins with a fever above 102 degrees F that lasts for at least five days. Other signs and symptoms may include: Rash anywhere on the body but more severe in the diaper area. Red, bloodshot eyes without pus, drainage, or crusting. Swelling and tenderness of a gland (lymph node) on one side of the neck. Swollen hands and feet with redness on the palms of the hands and the soles of the feet. Very red, swollen, and cracked lips; strawberry-like tongue with rough, red spots. Significant irritability and fussiness. Peeling fingers and toes (typically 2 to 3 weeks after the beginning of fever).

• #2 Kawasaki Disease – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/miscellaneous-disorders-in-infants-and-children/kawasaki-disease

  Kawasaki disease is a vasculitis, sometimes involving the coronary arteries, that tends to occur in infants and children between the ages of 1 year and 8 years. It is characterized by prolonged fever, exanthem, conjunctivitis, mucous membrane inflammation, and lymphadenopathy. […] The illness tends to progress in 3 phases: acute, subacute, and convalescent. […] The acute phase begins with fever lasting at least 5 days, usually 39 C (about 102.2 F) and unremittent when not treated with antipyretics. The fever is associated with irritability, occasional lethargy, or intermittent colicky abdominal pain. […] Within 5 days, a polymorphous, erythematous, macular rash appears, primarily over the trunk, often with accentuation in the perineal region. […] The acute phase ends with the resolution of fever.

• #2 Kawasaki Disease Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/965367-clinical

  Most children with KD are brought to medical attention because of prolonged fever. There are two forms of KD: complete and incomplete. Diagnosis of complete KD requires fever of at least 5 days’ duration along with 4 or 5 of the principal clinical features. The most recent version of the AHA guidelines suggest that if a patient presents with 4 or more of the principal criteria, KD can be diagnosed on day 4 of fever. Experienced clinicians who have treated many KD patients may establish diagnosis before day 4, and patients who present with coronary artery disease can be diagnosed if they have at least 3 of the 5 major diagnostic criteria. The principal clinical features are as follows: […] The acute stage begins with an abrupt onset of fever and lasts approximately 7-14 days. The fever is typically high-spiking and remittent, with peak temperatures ranging from 102-104F (39-40C) or higher. This fever is not responsive to antibiotics and can persist for up to 3-4 weeks if untreated. With appropriate therapy with IVIG, the fever typically remits within 36 hours.

• #2 Kawasaki disease Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/kawasaki-disease

  Kawasaki disease often begins with a fever of 102°F (38.9°C) or higher that does not go away. The fever is often as high as 104°F (40°C). A fever lasting at least 5 days is a common sign of the disorder. The fever may last for up to 2 weeks. The fever often does not come down with normal doses of acetaminophen (Tylenol) or ibuprofen. […] Other symptoms often include: Bloodshot or red eyes (without pus or drainage), Bright red, chapped, or cracked lips, Red mucous membranes in the mouth, „Strawberry” tongue, with white coating on the tongue, or visible red bumps on the back of the tongue, Red, swollen palms of the hands and the soles of the feet, Skin rashes on the middle of the body, not blister-like, Peeling skin in the genital area, hands, and feet (mostly around the nails, palms, and soles), Swollen lymph nodes in the neck (often only one lymph node is swollen), Joint pain and swelling, often on both sides of the body. […] Additional symptoms may include: Irritability, Diarrhea, vomiting, and abdominal pain, Cough and runny nose.

• #2 Kawasaki Disease | Children’s Hospital Los Angeles

  https://www.chla.org/kawasaki-disease

  The most common symptom of Kawasaki disease is a fever that lasts five days or longer. The fever may range from 101 to 104 degrees Fahrenheit or higher. […] Other symptoms include: Neck stiffness, Peeling skin on the hands, fingertips and toes, Red lips and tongue, commonly called strawberry tongue, Red or bloodshot eyes, Red rash on the torso, especially in the groin area, Redness and swelling on the palms of the hands and soles of the feet, Sensitivity to light, Stomach pain, Swelling and pain in the joints, such as the knees, hips and ankles, Swollen lymph nodes in the neck. […] Treatment for Kawasaki disease is most successful when it starts within 10 days of symptom onset. Your child may stay in the hospital for a few days or weeks, depending on how severe the illness is.

• #2 Kawasaki Disease: Causes, Symptoms, and Treatment

  https://www.webmd.com/children/what-is-kawasaki-disease

  Call your doctor if your child has these symptoms, including a fever between 101 F and 103 F that lasts more than 4 days. Early treatment can help lower their risk of lasting effects. […] If your child has Kawasaki disease, you’ll probably notice a rash in their genital area or in the area between their chest and legs. It’s likely to disappear in a week. It’s often flat and blotchy but can also have raised bumps. While the rash may look red on light skin, it can be harder to see on darker skin tones.

• #2 Kawasaki disease | Great Ormond Street Hospital

  https://www.gosh.nhs.uk/conditions-and-treatments/conditions-we-treat/kawasaki-disease/

  Kawasaki disease is a disease that causes swelling of the blood vessels throughout the body. It causes a high fever and rash. The symptoms of Kawasaki disease are like a lot of other more common childhood illnesses. The symptoms can come and go over a period of days and weeks, with new ones appearing. Initial signs can include: feeling unwell, fever (high temperature) over 38C for five days or longer, swollen lymph nodes (glands in the neck), rash (especially on the chest), palms of the hands and soles of the feet turn bright red, become puffy and the skin can peel, bloodshot eyes, redness on the inside of the lips and tongue and inside the mouth. […] Some children can have painful joints, tummy ache, diarrhoea and vomiting as well. For some children, the heart can be affected too. Around 20 to 40 per cent of children with Kawasaki disease develop problems in the blood vessels in the heart muscle. A bulge can develop in the wall of a heart blood vessel (coronary aneurysm). This can make it more likely for a blood clot to develop inside the vessel or it may become narrower as it heals. The valves inside the heart can also become leaky, so blood can flow backwards (regurgitation). The bag or sac that surrounds the heart can also fill up with fluid, putting pressure on the heart (pericardial effusion). These heart problems can lead to symptoms like breathlessness and chest pain.

• #2 Kawasaki Disease Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/965367-clinical

  The subacute stage begins when the fevers have abated, and it continues until week 4-6. The hallmarks of this stage are desquamation of the digits, thrombocytosis (the platelet count may exceed 1 million/L), and the development of CAAs. The risk for sudden death is highest at this stage. 20-40% of patients experience arthralgia or arthritis during this period, both of which tend to favor the large weight-bearing joints. Other characteristics of the subacute stage are persistent irritability, anorexia, and conjunctival injection. […] The convalescent phase is marked by complete resolution of clinical signs of the illness, usually within 3 months of presentation. This stage begins with the return to baseline of the acute phase reactants and other laboratory abnormalities. Deep transverse grooves across the nails (Beau lines) may become apparent 1-2 months after the onset of fever. During the convalescent stage, cardiac abnormalities may still be apparent. Smaller CAAs tend to resolve on their own (60% of cases), but larger aneurysms may expand, and MI may occur. In patients whose echocardiograms were previously normal, however, detection of new aneurysms is unusual after week 8 of the illness.

• #2

  https://www.nhs.uk/conditions/kawasaki-disease/symptoms/

  Your child may feel their hands and feet are tender and painful to touch or put weight on, so they may be reluctant to walk or crawl while these symptoms persist. […] Conjunctival injection is where the whites of the eyes become red and swollen. […] Your child’s lips may be red, dry or cracked. They may also swell up and peel or bleed. […] The inside of your child’s mouth and throat may also be inflamed. […] Their tongue may be red, swollen and covered in small lumps. This is known as „strawberry tongue”. […] If you gently feel your child’s neck, you may be able to feel swollen lumps usually on one side. The lumps could be swollen lymph glands. […] During the sub-acute phase, your child’s symptoms will become less severe, but may last a while. […] The high temperature should subside, but your child may still be irritable and in considerable pain.

• #2

  https://www.nhs.uk/conditions/kawasaki-disease/symptoms/

  Symptoms during the second phase of Kawasaki disease may include abdominal pain, vomiting, diarrhoea, pee that contains pus, feeling drowsy and lacking energy (lethargic), headache, joint pain and swollen joints, yellowing of the skin and the whites of the eyes (jaundice), peeling skin on the hands and feet, and sometimes also on the palms of the hands or the soles of the feet. […] Your child will begin to recover during the third phase of Kawasaki disease, which is known as the convalescent phase. […] Their symptoms should begin to improve and all signs of the illness should eventually disappear. […] But your child may still have a lack of energy and tire easily during this time.

• #2 Kawasaki Disease | AAFP

  https://www.aafp.org/pubs/afp/issues/1999/0601/p3093.html

  Coronary artery abnormalities develop in 20 to 25 percent of children with untreated Kawasaki disease. Abnormalities may include diffuse ectasia or coronary aneurysms. Patients who have giant aneurysms (maximum internal diameter of at least 8 mm) have the worst prognosis and are at greatest risk of developing coronary thrombosis, stenosis or myocardial infarction. […] If not treated within the first 10 days of illness, patients with Kawasaki disease who are younger than one year (especially those younger than eight months) have a substantially increased risk of developing coronary artery aneurysms. […] Myocardial infarction is the principal cause of death in patients with Kawasaki disease. Although infarction may occur during the acute phase of the disease, it more commonly occurs a year or even years later, especially in patients with giant aneurysms. Symptoms of myocardial infarction include inconsolable crying, vomiting, dyspnea, cardiovascular collapse and shock. Most documented cases of infarction have occurred during sleep or at rest.

• #2 Recognizing Kawasaki disease

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2805967/

  The subacute phase of KD begins when the fever resolves and lasts until symptoms and signs resolve usually between day 10 and 25 of the illness. It is at this time that characteristic desquamation of the skin at the fingertips and toes occurs. […] The convalescent phase of KD begins when all symptoms and signs resolve, and ends when the platelet count and ESR return to normal, usually 25 days to two months after the onset of fever.

• #2 Kawasaki Disease in Children | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/kawasaki-disease

  Kawasaki disease is an acute childhood illness that causes inflammation of the blood vessels in many areas of the body. If not treated early, it can cause damage to the coronary arteries, which supply the heart with oxygen. […] The symptoms of Kawasaki disease usually appear in phases, and can change or evolve over time. Symptoms of classic Kawasaki disease include: High fever, Rash, Redness or swelling of the hands, followed by peeling skin on the fingers or toes, Bloodshot eyes (both eyes), without drainage, Red, cracked lips, Strawberry tongue (a red, swollen tongue), Enlarged lymph node in the neck. […] Most children make a full recovery after Kawasaki disease, especially when diagnosed and treated early. Your child may be tired and irritable for a few weeks after they come home and may not feel 100 percent better until six to eight weeks after the illness.

• #2 For Parents

  https://pediatrics.ucsd.edu/research/centers/kawasaki-disease/for-parents/index.html

  A child’s tongue may be red and show small, raised bumps (papillae); a condition called „strawberry tongue” because the enlarged papillae resemble the seeds on a strawberry’s surface. […] The palms of the hands and soles of the feet often turn bright red. Hands and feet can swell. […] When the fever subsides, the rash, red eyes and the swollen lymph nodes usually disappear. Skin starts to peel around the toenails and fingernails, often beginning during the third week of illness. […] Occasionally, joint pain and inflammation persist after other symptoms have disappeared. Transverse (horizontal) depressed lines on fingernails and toenails, which occur during the illness, may be visible for months afterward until the nails grow out.

• #2 Kawasaki Disease | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/kawasaki-disease

  Kawasaki disease, also sometimes referred to as mucocutaneous lymph node syndrome, is an illness that causes inflammation (swelling) of medium sized blood vessels in the body. […] Kawasaki disease often goes away on its own, but if it is not treated it can cause serious injury to the heart and other organs. […] In some cases, the disease can affect the coronary arteries, which are blood vessels that supply oxygen-rich blood to the heart. This can cause serious heart problems. […] Fever lasting more than five days, often the fever wont resolve with Tylenol or Motrin. […] Redness in both eyes, without pus or discharge. […] Red, chapped lips and red, swollen tongue. […] Redness and/or swelling of the hands or feet. […] Red skin rash (including in the groin area). […] Swollen lymph nodes (in the neck).

• #2 Kawasaki Disease – Children’s Hospital of Orange County

  https://choc.org/heart/kawasaki-disease/

  The following are the most common symptoms of Kawasaki disease, though they do not have to all be present or present at the same time: Moderate-to-high fever (101.0° F to 104.0° F [38.3°C to 40.0°C]) that lasts for at least five days, swollen lymph nodes in the neck, rash, bloodshot eyes (bilateral conjunctivitis), dry, red, cracked lips or “strawberry tongue,” red, swollen palms of hands and soles of feet, peeling skin around the nail beds, hands or feet. […] Kawasaki disease may also cause the heart muscle (myocardium), as well as the membrane covering the heart (pericardium) to become irritated and inflamed. Irregular heart rhythms and heart valve problems may also occur with Kawasaki disease. […] In most cases, the effects on the heart caused by Kawasaki disease are temporary and resolve within 5 or 6 weeks. However, coronary artery problems may sometimes persist for a lifetime.

• #2 Frequently Asked Questions About KD | Rady Children’s Hospital

  https://www.rchsd.org/programs-services/kawasaki-disease-clinic/frequently-asked-questions/

  The palms of the hands and soles of the feet often turn bright red. Hands and feet can swell. Occasionally, a child may develop a stiff neck. The child usually has great difficulty getting comfortable and remains irritable as a result of the multiple signs and symptoms. […] When the fever subsides, the rash, red eyes and the swollen lymph nodes usually disappear. Skin starts to peel around the toenails and fingernails, often beginning during the third week of illness. The skin on a hand or foot may peel off in large pieces or even a single piece (much as a snake sheds its skin). Knees, hips, and ankles can become painful and the child may have difficulty walking. […] Occasionally, joint pain and inflammation persist after other symptoms have disappeared. Transverse (horizontal) depressed lines on fingernails and toenails, which occur during the illness, may be visible for months afterward until the nails grow out.

• #2 Kawasaki Disease: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/13457-kawasaki-disease

  Kawasaki disease symptoms can include: […] Symptoms of Kawasaki disease include fever, rash, belly pain and more. Kawasaki disease has many symptoms, like fever, red tongue, rash and belly pain. […] Kawasaki disease symptoms can include: Fever lasting for at least five days. Irritability. Red or pink eyes without discharge. Redness or cracking of your child’s lips or tongue. Swelling and/or redness of your child’s hands or feet. Peeling of your child’s skin, usually beginning around their nails. Rash, mostly on your child’s trunk, but sometimes elsewhere. Swollen lymph node(s) in your child’s neck. Upset stomach or belly pain. […] The three stages of Kawasaki disease are: Stage 1 (Acute) Fever for five days or more. Rash around the trunk or groin. Pink eye. Red tongue and lips. Red skin on hands and feet (palms and soles). Swelling in lymph nodes.

• #2 Kawasaki Disease (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/kawasaki.html

  Kawasaki disease is an illness that causes inflammation (swelling and redness) in blood vessels throughout the body. It happens in three phases, and a lasting fever usually is the first sign. […] The first phase, which can last for up to 2 weeks, usually involves a fever that lasts for at least 5 days. […] Other symptoms include: red („bloodshot”) eyes, a pink rash on the back, belly, arms, legs, and genital area, red, dry, cracked lips, a „strawberry” tongue (white coating with red bumps on the tongue), a sore throat, swollen palms of the hands and soles of the feet with a purple-red color, swollen lymph glands in the neck. […] The second phase usually begins 2 weeks after the fever started. Symptoms can include: peeling skin on the hands and feet, joint pain, diarrhea, vomiting, belly pain.

• #2 Kawasaki disease – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/kawasaki-disease/symptoms-causes/syc-20354598

  Symptoms of Kawasaki disease include a fever greater than 102.2 degrees Fahrenheit (39 degrees Celsius) for five or more days. And the child has at least four of the following symptoms. […] Children with Kawasaki disease might have high fever, swollen hands and feet with skin peeling, and red eyes and tongue. […] The symptoms might not happen at the same time. Let your child’s healthcare professional know about a symptom that has gone away. […] Some children get a high fever for five or more days but have fewer than four of the symptoms needed for a diagnosis of Kawasaki disease. They might have what’s called incomplete Kawasaki disease. Children with incomplete Kawasaki disease are still at risk of damage to the heart arteries. They still need treatment within 10 days of when symptoms appear. […] Kawasaki disease can have symptoms like those of a condition called multisystem inflammatory syndrome in children. The syndrome happens in children with COVID-19.

• #2 Kawasaki disease | Great Ormond Street Hospital

  https://www.gosh.nhs.uk/conditions-and-treatments/conditions-we-treat/kawasaki-disease/

  The risk of developing heart problems is lessened with prompt diagnosis and treatment. If heart problems have not developed within a few weeks of diagnosis, they unlikely to occur. Children can also have Kawasaki disease without showing all the symptoms above this is often referred to as atypical Kawasaki disease. This is more common in younger children.

• #2 Kawasaki disease

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4323050/

  Kawasaki disease (KD) is an acute febrile multisystem vasculitis of unknown etiology affecting most often children younger than 5 years of age. It is a unique clinical symptom complex characterized by persistent high fever, bilateral conjunctival hyperemia, mucosal changes of the oropharynx, erythematous rash, erythema and indurative edema of the hands and feet, and cervical lymphadenopathy. […] Although KD is of a self-limited nature, approximately 20-25% of untreated patients develop coronary artery changes with a range of severity from asymptomatic coronary artery dilatation or aneurysms to giant coronary artery aneurysms with thrombosis, myocardial infarction and sudden death. […] In the absence of a diagnostic test for KD, the diagnosis is established by the presence of six principal symptoms.

• #2

  https://www.beaumont.org/conditions/kawasaki-disease

  Kawasaki disease tends to have a very quick onset, but its symptoms occur in three phases acute, subacute, and convalescent. Children may experience heart trouble in as soon as 10 days after symptoms start, so its important to seek treatment right away. […] Symptoms include: Fever above 101F that doesnt respond well to fever reducing medications and lasts more than five days […] Heart rhythm irregularities […] Swollen, bright red tongue […] Kawasaki disease causes inflammation of the blood vessels, which can damage the coronary arteries. It also causes problems with the lymph nodes, skin, mouth, nose, and throat. […] About one-quarter of children who have Kawasaki disease may experience heart effects. It causes inflammation of and damage to the coronary arteries and the heart itself. When coronary arteries are weakened, an aneurysm may occur, which can be deadly. Infants are at greatest risk for heart complications, and they tend to become more seriously ill than older children who develop the disease.

• #2 Kawasaki Disease | Symptoms, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/k/kawasaki

  Kawasaki disease can affect the heart by causing the following complications: Coronary artery aneurysms (or ballooning of the arteries), Leakage of valves (often mitral valve regurgitation), Build-up of fluid around the heart (pericardial effusion). Kawasaki disease is the leading cause of acquired heart disease in children. In as many as 25% of children with Kawasaki disease, the heart becomes affected without proper treatment. Aneurysms of the coronary arteries, the blood vessels that supply oxygen to the heart itself, are the most important complication of Kawasaki disease. With appropriate and timely treatment, the risk of coronary artery involvement decreases to around 5%. […] If a coronary aneurysm develops, the presence of long-term coronary artery changes depends on the size of the aneurysm the coronary artery changes can resolve, remain unchanged, or progress. Patients with large aneurysms are at risk for developing coronary artery clots or stenosis (narrowing) as the aneurysms heal.

• #2 Kawasaki disease

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4323050/

  The symptoms of KD can be classified into two categories, principal symptoms and other significant symptoms or findings. For diagnosis of KD, at least five items of 1-6 should be satisfied. However, patients with four items of the principal symptoms can be diagnosed as KD when coronary artery aneurysms or dilatation is recognized by two dimensional echocardiography or coronary angiography. […] The most important clinical problem in KD is cardiovascular lesions, which may cause sudden death or develop into coronary artery disease. […] In the early phase of the illness, pericarditis, myocarditis, endocarditis and coronary arteritis are present and exhibit mild to severe manifestations in most KD patients. […] If KD can be diagnosed within 1 week of onset and if IVGG treatment can be started early, coronary artery changes would be prevented in less than 5% of all patients. There are still 10-15% of cases resisting IVGG in the lowering of fever and need retreatment. However, giant aneurysms in a few patients (0.4%) have developed despite the fact that IVGG treatment was started within 7 days of onset. If diagnosis is delayed until 10 or more days after onset, the risk of coronary artery changes rapidly increases.

• #2 How to Spot Kawasaki Disease in Your Child – The New York Times

  https://www.nytimes.com/2024/02/27/health/kawasaki-disease-symptoms.html

  About 25 percent of Kawasaki disease patients who do not get treatment for the condition will develop aneurysms of the coronary arteries, which could lead to heart attacks and death even years later. […] The good news is that, as long as Kawasaki disease is detected and treated within a few days, outcomes tend to be positive. Patients are admitted to the hospital and given a hefty infusion of intravenous immunoglobulin, or IVIG, a concoction of antibodies, to quickly calm the inflammatory response. […] Together with high doses of aspirin, the infusions can lower the fever, reduce swelling and prevent heart damage. After the inflammation subsides, an echocardiogram can confirm that the heart still looks healthy.

• #2

  https://www.healthychildren.org/English/health-issues/conditions/heart/Pages/Kawasaki-Disease.aspx

  If Kawasaki disease is left untreated, it can lead to serious complications such as inflammation of the blood vessels. This can be particularly dangerous because it can affect the coronary arteries–the blood vessels that supply blood to the heart muscle–causing coronary artery aneurysms to develop. […] Fortunately, treatment within the first 10 days of illness significantly decreases the risk of aneurysms. […] Children diagnosed with Kawasaki disease are admitted to the hospital. The medication used to treat Kawasaki disease in the hospital is called intravenous gamma globulin (IVIG). […] Children treated for Kawasaki Disease are sent home from the hospital on a low dose of aspirin to take by mouth every day for 6 to 8 weeks. […] It is very important to closely monitor children who have had Kawasaki Disease to make sure they are improving and to check for the development of coronary aneurysms. […] Children treated for Kawasaki disease who do not develop aneurysms have an excellent long-term outcome. However, it is important for them to follow a heart healthy diet and lifestyle.

• #2 Kawasaki Disease | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/kawasaki-disease

  Irritability and/or fussiness. […] Less common: abdominal pain, joint pain. […] Treatment should begin soon after the diagnosis, especially within the first 10 days of illness. […] The treatment helps stop the fever, improves symptoms, and prevents damage to the heart blood vessels. […] Most children with Kawasaki disease respond quickly to the IVIG and fully recover, but some children need more IVIG or other treatments like steroids to help with the symptoms. […] Children diagnosed with Kawasaki disease will need to be seen regularly by a cardiologist after leaving the hospital to make sure their heart is not affected. […] At the cardiology visits, your child will get repeat echocardiograms to check for inflammation of the heart vessels. It is very important to keep these appointments. […] Children usually receive a low dose of aspirin for at least six to eight weeks until the cardiologist makes sure there is no damage to the heart blood vessels.

• #2 Kawasaki Disease | Symptoms, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/k/kawasaki

  Treatment includes intravenous gamma globulin (IVIG), which is an infusion through your child’s IV and high-dose aspirin every six hours. These medicines help reduce the swelling and inflammation in the blood vessels. IVIG can decrease, but NOT eliminate, the risk of developing coronary aneurysms. The infusion is most effective if given within the first 10 days of the illness, decreasing the risk of developing coronary changes from 25% to less than 5%. […] If after one year from the diagnosis of Kawasaki disease there is no heart involvement, your child’s cardiology visits are spaced out to annual visits or even every few years. Patients that have coronary aneurysms require periodic cardiology evaluations. The frequency of these visits varies depending on the extent of coronary changes. Often these visits are scheduled once every six to 12 months. With the right medical care, these patients also generally have a good prognosis.

• #2 Kawasaki disease long-term effects | Norton Children’s Louisville, Ky.

  https://nortonchildrens.com/news/long-term-effects-of-kawasaki-disease-include-dangerous-heart-issues/

  “Unfortunately, young adults often will consider a childhood disease as ancient history. They feel fine now and consider themselves cured,” said Walter L. Sobczyk, M.D., pediatric cardiologist with Norton Children’s Heart Institute and an adult congenital heart disease specialist. “But in reality, they may still have a dangerous heart condition that can strike with little warning, and they need to stay on top of their health.” […] Those with heart issues resulting from Kawasaki disease typically are advised to avoid a sedentary lifestyle. Inactivity is just as dangerous as over-activity, because it allows clots to form in arteries.

• #2 Kawasaki Disease Signs & Symptoms | Rush | Rush System

  https://www.rush.edu/kids/conditions/kawasaki-disease

  In the third phase, signs and symptoms slowly go away unless complications develop. […] Starting treatment within 10 days of onset of symptoms typically limits the chances of serious complications. With early diagnosis and treatment, most children make a full recovery. […] Your child will need to be admitted to the hospital, at least for early treatment of KD. Treatment must be started as soon as possible, preferably while the fever is high. […] Medication are the main treatments for Kawasaki disease. Most often, children receiving these treatments improve within 24 hours. […] Most children recover completely from the acute phase and do not need further treatment. However, Kawasaki disease is a leading cause of acquired heart disease in the U.S. You child should be monitored with regular echocardiograms, EKGs and stress tests.

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