Kawasaki Disease: Cheat Sheet & Quiz

Pathophysiology & Risk Factors

Kawasaki disease is an acute inflammation of small and medium arteries, and it happens overwhelmingly in children under five. The cause is unknown. What matters clinically is where the inflammation lands: the coronary arteries. Left untreated, roughly a quarter of children develop coronary aneurysms, which can thrombose or rupture years later. Treatment given inside the first ten days of fever drops that risk dramatically, so this is a disease where the nursing job is recognition and speed rather than long-term management.

Signs & Symptoms

EarlyProgresses →

fever for five days or more Hallmark

high, and does not respond to antibiotics — the entry finding

bilateral red eyes without drainage Hallmark

conjunctivitis with nothing coming out of the eye

cracked red lips and strawberry tongue Hallmark

red swollen hands and feet

widespread rash on the trunk

one large swollen neck node

extreme irritability Hallmark

out of proportion to the rest of the illness; a classic feature

Late / Severe

peeling skin on the fingers and toes

appears in the second and third weeks

Interventions & Priorities

Suspected Kawasaki disease — the sequence that matters

Count the fever daysfive or more is the entry point
Baseline echocardiogramlook at the coronary arteries
IVIG within 10 daysthis is what prevents aneurysms
Start aspirinhigh dose, then low dose
Repeat the echocoronaries are followed for months

Treatments & Medications

intravenous immunoglobulin Hallmark

given inside 10 days; prevents coronary aneurysms

aspirin Hallmark

used here despite the usual pediatric caution — high dose for inflammation, then low dose to stop clots

a second IVIG dose

if the fever returns or never breaks

corticosteroids

for children who do not respond to IVIG

Patient Teaching

delay live vaccines for about eleven months after IVIG Hallmark

donated antibodies block the child's response to the vaccine

keep every follow-up echocardiogram appointment Hallmark

expect peeling fingers and toes in weeks two and three

report flu or chickenpox exposure while on aspirin

Reye syndrome risk during those illnesses

irritability can last for weeks

give the aspirin exactly as prescribed

Report Nowescalate immediately

fever that returns after IVIG Hallmark

suggests the first dose did not work; a second is often needed

chest pain or a child clutching the chest Hallmark

possible coronary involvement

new dysrhythmia or gallop rhythm

signs of heart failure during the IVIG infusion

fever beyond day ten before treatment is started

Clinical Pearl

Five days of fever plus red eyes, red lips and a strawberry tongue in a toddler — get the echocardiogram and the IVIG, because the coronaries are the disease.

Kawasaki Disease

Pathophysiology & Risk Factors

Signs & Symptoms

Interventions & Priorities

Treatments & Medications

Patient Teaching

Compare & Contrast

Kawasaki Disease vs Rheumatic Fever: Two Post-Infectious Cardiac Inflammations in Children

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