Signs and symptoms of Kawasaki disease
Physicians and researchers within the Division of Infectious Disease were able to diagnose and treat Andre's Kawasaki disease when others could not.
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Clinical features
Fever and irritability often occur first in Kawasaki disease. The fever fluctuates from moderate (101-103° F) to high (104° F). The fever can continue to rise and fall for as long as 3 weeks if not treated.
Rash usually develops early in the illness on the chest, back, diaper area and abdomen. In some cases, the rash may spread to the face, arms and legs. Often bright red in appearance, the rash usually consists of poorly defined spots and blotches of various sizes, but sometimes has other appearances.
Hands and feet may become red and swollen. Occasionally, swollen and painful joints (knees, hips, ankles or fingers) or a stiff neck will develop. Skin peeling beginning around the fingernails or toenails may occur around 14-21 days.
Blood-shot eyes may develop, as well as sensitivity to light. There is usually no drainage from the eyes.
Irritation and inflammation of the lips may develop, and they appear red, dry, swollen or cracked. The inside of the mouth may become more red than usual. The tongue may be coated, slightly swollen and red and is often described as a “strawberry tongue.”
Lymph glands in the neck may become swollen, usually limited to one side of the neck. This is the least common of the major clinical features of Kawasaki disease.
Other complaints can include abdominal pain, vomiting, diarrhea, cough, listlessness and irritability.
Laboratory workup
Blood tests may detect a number of abnormalities often seen early in the illness:
- Mild anemia for age
- Elevated white blood cell (WBC) count
- Elevated alanine aminotransferase (ALT) test (checks for liver enzymes)
- Elevated erythrocyte sedimentation rate (ESR) test (checks for inflammation)
- Elevated C-reactive protein (CRP) level (checks for inflammation)
- Low sodium level
- Low albumin level
A finding often seen later in the disease:
- Elevation of platelet count (the blood clotting component)
Urinalysis may detect white cells in the urine.