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Kawasaki's Disease

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Medical Author:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Medical Editor:

Catherine Burt Driver, MD

Catherine Burt Driver, MD

Catherine Burt Driver, MD, is board certified in internal medicine and rheumatology by the American Board of Internal Medicine. Dr. Driver is a member of the American College of Rheumatology. She currently is in active practice in the field of rheumatology in Mission Viejo, Calif., where she is a partner in Mission Internal Medical Group.

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What is Kawasaki's disease?

Kawasaki's disease is an uncommon illness in children that is characterized by high fever of at least five days' duration together with at least four of the following five findings:

1. Inflammation with reddening of the whites of the eyes (conjunctivitis) without pus



2. Redness or swelling of the hands or feet, or generalized skin peeling



3. Rash



4. Lymph node swelling in the neck



5. Cracking inflamed lips or throat, or red "strawberry" tongue

The above criteria are used to make a diagnosis of Kawasaki's disease. The terminology "incomplete Kawasaki's disease" is sometimes used for patients with only some features of classical Kawasaki's disease.

What is mucocutaneous lymph node syndrome?

Mucocutaneous lymph node syndrome is the original name for Kawasaki's disease. The original name was quite descriptive because the disease is characterized by the typical changes in the mucous membranes that line the lips and mouth and by the enlarged and tender lymph nodes.

What are the usual symptoms and signs of Kawasaki's disease?

The usual symptoms and signs of Kawasaki's disease include

• fever,



• reddening of the eyes,



• cracked and inflamed lips and mucous membranes of the mouth with an inflamed "strawberry" tongue,



• ulcerative gum disease (gingivitis),



• swollen lymph nodes in the neck (cervical lymphadenopathy),



• and a rash that is raised and bright red.

The rash appears in a glove-and-sock fashion over the skin of the hands and feet. The rash becomes hard, swollen (edematous), and then peels off.

What are the less common findings?

Most of the common symptoms described above will resolve without complications, even if untreated. Less common findings include inflammation of the lining of the heart (pericarditis), joints (arthritis), or covering of the brain and spinal cord (meningitis), and the other heart complications listed below in the section on serious complications. The outlook (prognosis) for an individual affected is primarily determined by the seriousness of any heart complications.

What is the difference between Kawasaki's disease and Kawasaki's syndrome?

They are the same. Kawasaki's disease is also referred to as Kawasaki's syndrome. It was first described in the late 1960s in Japan by the pediatrician Tomisaku Kawasaki.