Could Your Child’s Persistent High Fever, Swollen Lymph Nodes And Rash Be Kawasaki Disease (KD)?

Kawasaki disease (KD) is also known as Kawasaki syndrome, lymph node syndrome, mucocutaneous lymph node syndrome or polyarteritis. It is believed that KD is an autoimmune disease that affects the medium size blood vessels in the body. This disease is usually diagnosed in children younger than 5 years old. Kawasaki disease occurs most frequently in Japan but it is also seen in children here in the United States.

KD causes inflammation of the blood vessels and can affect many organs with the most serious being the heart. If left untreated it can lead to fatal coronary artery aneurysms or a heart attack. It can also lead to neurologic complications such as seizures, a lack of blood flow to the brain, stroke, facial palsy, coma or even death. Death is most common 2 to 12 weeks after the onset of illness.

Kawasaki Disease often starts with a high fever, greater than 102 F, that can last anywhere in between 5 and 25 days. The fever usually does not go away with Tylenol, acetaminophen, Motrin or ibuprofen. Other symptoms that may be present often include:

• Very red or bloodshot eyes
• Bright red cracked or chapped lips
• Beet red tongue with red bumps and a white coating
• Red palms and soles of the feet
• Swollen hands and feet
• A skin rash on the trunk
• Peeling skin in the genital area, palms or soles
• Swollen lymph nodes in the neck
• Joint aches and pains

There are no specific tests that can diagnose Kawasaki disease. The diagnosis is usually suspected if a child presents with most of the classical symptoms of KD. If Kawasaki disease is suspected the following tests may be ordered:

• Chest x-ray
• A complete blood count or CBC to check for anemia
• C-reactive protein (CRP)
• Sedimentation rate or ESR
• Albumin level
• Liver studies
• Urinalysis to check for pus or protein in the urine
• Electrocardiogram or EKG
• Echocardiogram or Heart Echo
• Ultrasound of the abdomen, gallbladder or liver
• A lumbar puncture to check for meningitis
• Angiography to look for aneurysms
• Temporal artery biopsy to see if there is inflammation of the artery

A child with suspected Kawasaki disease must be admitted to a children’s hospital and cared for by a physician who has experience in treating KD. The hospital should also have on staff pediatric cardiology, pediatric rheumatology, and pediatric infectious disease specialists. It is very important that treatment be started as soon as possible to prevent serious damage to the coronary arteries.

Standard treatment for KD usually consists of Intravenous immunoglobulin (IVIG) and high dose aspirin. Because children with Kawasaki disease will have to take aspirin for a few months, vaccinations against varicella and influenza are required since those viruses or infections and aspirin can lead to Reye’s syndrome. Some studies show that steroids may also improve a child’s outcome but more research is needed to see if they really are a benefit or not. With early diagnosis and treatment of KD a full recovery can be expected.

If there was a delay in diagnosing and treating your child’s Kawasaki disease it may have been due to medical malpractice. You should speak with a law firm that has experience in childhood illnesses and diseases. Here at the Philadelphia Beasley Law Firm we have on staff lawyers, doctors and nurses who have the pediatric medical knowledge that other law firms do not have. Please feel free to contact one of our experienced child medical malpractice team members for a strictly confidential and free consultation.