Treatment

• IV immunoglobulin (IVIG)

  • High single-dose to reduce the risk of coronary artery aneurysms

  • Most effective if given within the first 10 days following disease onset

• High-dose oral aspirin

• IV glucocorticoids: may be considered in addition to standard treatment, esp. in cases of treatment-refractory disease, as they lower the risk of coronary involvement

To avoid the risk of Reye syndrome, children should not be treated with aspirin, especially if a viral infection is suspected. Kawasaki disease is an exception to this rule.

• Coronary artery aneurysm

  • The risk of aneurysms is highest during the second and third weeks following symptom onset.

  • Rupture or thrombosis of the aneurysm can be lethal.

• Myocardial infarction

• Myocarditis

• Ventricular dysfunction

  • Most commonly occurs within the first 2 weeks of onset of Kawasaki disease

  • Often seen in infants with untreated Kawasaki disease

  • Most commonly associated with lymphocytic myocarditis

  • Manifests with symptoms (e.g., tachypnea or diaphoresis with feeding, exertional dyspnea) and physical examination findings of congestive heart failure (e.g., hepatomegaly, S3 gallop, rales or crackles on lung auscultation)

  • Increased risk of sudden death

  • Arrhythmias