Kawasaki disease
For toddlers with Kawasaki disease, fever is just one of the early signs of a very serious illness.
Kawasaki disease, or Kawasaki syndrome, is an infectious inflammatory disease that affects mainly infants and young children. At first, the symptoms - fever, rash, watery eyes, swollen lymph nodes - look like those seen with many of the bugs kids pick up all the time.
But this is no simple bug. It affects many systems in youngsters' bodies, but damage to the heart and surrounding tissue are of the greatest concerns. Left untreated, Kawasaki disease can damage the coronary arteries that feed the heart, possibly causing a massive heart attack.
Although there have been rare reports of Kawasaki disease in adults, the disease primarily affects children under 5 years old, with most cases affecting 1- to 2-year-olds. The disease affects boys about 50% more often than girls, and seems to affect children of Asian descent at a much higher rate than children of African or European descent.
Fever develops within the first few days of onset of the disease. Many Kawasaki patients experience abrupt spikes in temperature - several spikes a day for five or more days - as the disease begins. Left untreated, the spiking can continue for as long as four weeks.
A measles-like rash usually accompanies the fever, and lymph nodes in the neck swell. Conjunctivitis, characterized by red eyes and swollen eyelids, may also develop in the first few days. The lips, tongue and throat may become red and swollen. One of the most distinguishing symptoms of Kawasaki disease is the redness and swelling of palms and soles within a few days of onset. After a couple of weeks, the skin of the hands and feet begins to peel.
Early and accurate diagnosis is critical to successful treatment, as the disease can start to damage the heart after just one week of illness.
But diagnosis is difficult. One problem is that the symptoms don't always appear together. Some patients experience all of the symptoms, and some have only a few. Infants are less likely than toddlers to have all symptoms.
Although heart inflammation may subside over time, aneurysms, permanent and sometimes life-threatening dilations of blood vessels, may occur.
A Kawasaki patient's long-term outlook depends on how much damage is done to the heart. Patients who receive treatment early will likely suffer no damage to the arteries. More than half the children who do develop aneurysms recover within a year. Doctors don't yet know if there are any long-term effects that aren't apparent when the acute phase of the disease ends.
Source: National Institutes of Health
