Kawasaki is a childhood disease involving children less than 5 years of age. It may present with varying manifestation ranging from fever to involvement of coronary circulation.
Fever for 5 days associated with conjunctivitis (non-exudative type), rash, adenopathy which is mostly cervical lymphadenopathy and mucosal involvement. The most dreaded complication if seen is coronary artery aneurysm. It is the only complication which can lead to death at a young age. Timely diagnosis if suspecting Kawasaki can save a life.(1)
It is not necessary that the disease is present with all the manifestation at first but yes definitely a history of fever associated with cervical lymphadenopathy is seen. Strawberry tongue is pathognomonic of the disease.
The treatment of choice is IV immunoglobulin. Usually, in the normal course, the disease gets cured within 12 days. This is the average time taken to get into remission.
It is all the matter of timely diagnosis and treatment. It is observed that timely diagnosis can be really helpful as many patients start improving after the first dose of iv immunoglobulin. As soon as the child receives immunoglobulin fever subsides. As per a few studies it is found out that coronary involvement will not occur when the child is treated within 10 days of the disease diagnosis. (1)
Mostly within 2 days, all symptoms subside but once coronaries are involved the course of the disease might get prolonged. The child might show features of vasculitis if not treated.
If the doctor is suspecting that disease in its long run will involve coronaries then definitely put the child on aspirin to prevent heart problem. But as we all know aspirin can cause Reye syndrome in a child who is taking aspirin so it is advised that if any signs of flu if appeared immediately report to the hospital.
Viral infection can be precipitated so it the duty of parents to look for all the symptoms on a regular basis. Be very careful during the winter months.
Many times a single dose is enough to cure the child completely but that is not so always. Many patients do not recover completely even after multiple doses. Cardiac echo on a regular basis should be done. Many patients might have cardiac problems for life long. In such a case, the only way is to have a regular check-up. A careful attitude is important for the disease.
Many patients, in fact, have arrhythmias in early life. Those kinds of the patient are at high risk of dying in the later stage of life. Valvular involvement may occur but it is quite rare.
One per cent chance is there that a child may die because of Kawasaki disease. Parents should be properly counseled. Many diseases might mimic Kawasaki like Rocky mountain fever and juvenile arthritis in such cases proper investigations should be done to rule out these diseases and reach to diagnosis.
It is a commonly asked question by the parents how long my child will take to recover completely? The answer to this question is not fixed as few children might get normal within 2 days while others may take years. But it is for sure coronaries ones get involved it is difficult to get completely cured. The only thing is to prevent aneurysmal rupture. This is the life-threatening condition and child definitely dies.(2)
Many times patient cannot afford that treatment as IV immunoglobulin is a costly drug. In such case at least make sure that coronaries are not involved. For the one who is less likely to have coronaries involvement, do not perform an echo as it cost a lot. So while providing treatment patient’s affordability must be considered once. As there are many patients who misses the treatment because they cannot afford it so prescribing what is needed in such cases is the art. A good doctor is one who treats the patient considering his condition.
Initially Kawasaki was not a curable disease but definitely, now it is. Only thing is time management and diagnosis.
Also Read:
- Kawasaki Disease: Causes, Symptoms, Treatment, Prognosis
- Can Kawasaki Disease Go Away By Itself?
- Can You Die From Kawasaki Disease?
- How Did My Child Get Kawasaki Disease?
- Natural Remedies For Kawasaki Disease
- What Is The Most Likely Cause Of Kawasaki Disease?
- Is There An Alternative Treatment For Kawasaki Disease?
- Is Kawasaki Disease Lifelong?
