Recognizing The Symptoms of Kawasaki Disease

If your child is currently younger than 5 years, you should observe if they have Kawasaki Syndrome, or well-known as Kawasaki Disease. Due to unknown causes, this acute febrile illness can primarily affect most children who are younger than 5 years of age. Tomisaku Kawasaki first described the disease in 1967, while the first cases outside of Japan were reported in 1976 in Hawaii, according to the Centers for Disease Control and Prevention. 

In the United States, Kawasaki Disease is said to be a leading cause of heart disease. This condition occurs worldwide and can usually affect younger children and boys. According to reports, community-wide outbreaks and winter-spring seasonality occur occasionally. This condition can affect various parts of your body since it’s characterized by inflammation of the blood vessels. The disease usually starts when a child has a high fever lasting for five days. Then the child can experience symptoms that are mentioned below as you read through this vlog..

Abdominal pain

Abdominal pain can be felt by numerous children who have the disease despite it not belonging to the classic diagnostic criteria. Associated with Kawasaki disease, abdominal pain is often severe and can be accompanied by other symptoms of gastrointestinal condition such as diarrhea and vomiting. 

When abdominal pain and other characteristic symptoms of the disease may raise suspicion for the illness. But it’s important to note that abdominal pain can also occur due to various conditions besides being a Kawasaki disease symptom. It’s crucial to seek medical help immediately if your child is frequently experiencing abdominal pain when it’s accompanied by symptoms such as redness of the lip and tongue, fever, swollen lymph nodes, and rash.

Swollen lymph nodes 

Recent studies show that 80% of children with the disease have enlarged lymph nodes. Your child may experience painless lumps under the skin, specifically in the groin or neck area, and it can also be small and hard. This symptom is one of the key diagnostic criteria by healthcare professionals to help identify Kawasaki disease. 

The enlarged lymph nodes in the neck will be presented by more than half of patients with at least 1.5 cm of single lymph nodes, according to the Information on Pediatric Rheumatic Diseases. In fact, Kawasaki disease was previously called mucocutaneous lymph node syndrome because it causes swelling in mucous membranes and glands (lymph nodes) in areas such as the throat, eyes, mouth, and nose. 


Conjunctivitis refers to conjunctiva inflammation. This covers the white part of the eye and lines the inside of the eyelids in the form of thin, clean tissue. Basically, this symptom presents irritation and redness in the eyes. There may be swelling of the conjunctiva, and the whites of the eyes may appear bloodshot. Associated with Kawasaki disease, conjunctivitis affects both eyes, making it bilateral.

Conjunctivitis, in relation to the disease, tends to spare the limbus. Bilateral nonexudative conjunctivitis is present in 90% of patients with Kawasaki disease, and it typically begins within the days of the onset of fever. Also, patients may develop anterior uveitis. Viral or bacterial infections can also occur due to conjunctivitis, aside from being a symptom of Kawasaki disease.


Expect your child to feel constantly irritated due to the impact of Kawasaki disease. Which means it may be a challenge for you to handle them, specifically to take them into bed or take care of them daily. But you need to remember that this is a symptom that’s inevitable to happen if they have the disease. Children can be fussy and irritable as they’re experiencing this disease.

However, atypical or incomplete Kawasaki disease shows mild impacts on children. If not treated right away, both forms can damage the blood vessels. Irritability may manifest in your child through restlessness and crying, which can be challenging to handle. According to a documented observation, children experience extreme irritability during the acute phase of the illness. But this can be resolved after you consult your doctor for treatment. 


A rash is a common symptom of Kawasaki disease, in which this rash forms in the genital area or between the leg and chest area. Within one week, your child can kiss the rash goodbye, for it will disappear. During the first few days of the onset of fever, a rash in Kawasaki disease appears. This phase is known as the acute febrile phase. A rash is never vesicular, but it’s polymorphous that varies from macular to maculopapular or morbilliform. 

Over the next few days, it will commonly spread from starting on the trunk, involving extremities. During the first week of illness, rask over the perineal area often undergoes desquamation. And it usually disappears along with the resolution of fever. It’s important to keep in mind that the rash in the disease can be non-blanching; it does not lose or fade color when pressed.  

Persistent fever

The first clinical manifestation of Kawasaki disease is usually persistent fever. This is specific in terms of a 40 Celsius high-grade fever that’s not responding to antimicrobials and antipyretics. Patients with the disease who have fever reflect underlying inflammation of the vessel wall, according to the National Library of Medicine. This becomes less prominent in older children than younger patients associated with extreme irritability. 

Despite the interventions of typical-fever reducing medications, it still tends to persist. The fever may temporarily subside but can still reoccur during the course of the illness. Along with persistent fever, several signs may occur over the next several days. Your child’s hands and feet may get very swollen and red, specifically in the soles and palms. 

Red, cracked lips

You can immediately tell if your child has Kawasaki disease if their lips begin to be red, dry, and cracked. They may also swell up and peel or bleed. The inside of the throat and mouth of your child may be inflamed as well. They may have the “strawberry tongue,” which refers to the tongue being red, swollen, and covered in small lumps.

Aside from the impact of the disease, it’s important to note that irritants or dry weather may also be factors that lead to your child’s red and cracked lips. In the case of Kawasaki disease’s involvement with severe lip and oral mucosa, there may be changes in the lips and oral activity in your child. This includes dryness, erythema, peeling, fissuring, bleeding of the lips, and vertical cracking; a strawberry tongue with prominent fungiform papillae and erythema. 

Redness and swelling of the hands and feet

Your child’s skin on their hands and feet may become red or hard and may swell up, according to NHS UK. They may be reluctant to walk or crawl while symptoms of their hands and feet being painful and tender to touch or put weight on persist.

This symptom is also called “Kawasaki disease extremity changes.” In the later stages of the illness, the skin on the palms of the hands and the soles of the feet may undergo a desquamation or peeling process. As a result, this peeling can appear as if it had been sunburned or when a sock or glove has been removed.


If your child already has a high fever as a symptom of the disease, they may eventually experience fatigue along the process. This will discourage them from doing physical activities like walking or crawling. You can determine their fatigue level depending on their fever temperature. Which is why it’s important to monitor your child’s condition to prevent severe effects of the disease.

During the acute phase of the disease, your child may experience a high fever that will last for more than 5 days. Along with high fever are other symptoms such as abdominal pain, extreme irritability, and especially fatigue. Your child may experience this fatigue for four to six weeks after the acute illness. 

Intestinal problems

According to doctors who published cases in the Journal of Pediatrics, 48 cases were published of Kawasaki’s disease with intestinal involvement. Vomiting, abdominal pain, and fever were generally the first or early manifestations. These manifestations occur before the appearance of mucocutaneous findings.

Cases from plain radiographs or another imaging study showed that pseudo-obstruction was 80% present. It was not typical for hydrops of the gallbladder to occur. 25% of patients underwent surgery, so the disease was not an early consideration. At the time of Kawasaki disease diagnosis, coronary artery aneurysms were present in 43% of cases. 


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