How Is Kawasaki Disease Diagnosed?

Kawasaki disease is diagnosed based on your child's signs and symptoms and the results from diagnostic tests and procedures.

Specialists Involved

Pediatricians often are the first to suspect a child has Kawasaki disease. Pediatricians are doctors who treat children.

If the disease has affected your child's coronary arteries, a pediatric cardiologist will confirm the diagnosis and give ongoing treatment. Pediatric cardiologists treat children who have heart problems.

Other specialists also may be involved in treating children who have Kawasaki disease.

Signs and Symptoms

The doctor will check your child for the classic signs and symptoms of Kawasaki disease.

The doctor will rule out other diseases that cause similar symptoms. These diseases include Rocky Mountain spotted fever, scarlet fever, and juvenile rheumatoid arthritis.

Generally, your child will be diagnosed with Kawasaki disease if he or she has a fever that lasts longer than 5 days plus four other classic signs or symptoms of the disease.

However, not all children have classic signs and symptoms of Kawasaki disease. Diagnostic tests and procedures can help confirm whether a child has the disease.

Diagnostic Tests and Procedures

Echocardiography

All children suspected of having Kawasaki disease have a test called echocardiography (EK-o-kar-de-OG-ra-fee). This painless test uses sound waves to create images of the heart. These pictures show the coronary arteries.

Doctors use the test when they suspect a child has the disease, but the child has fewer than four of the five classic signs.

Echocardiography also can help show the disease's effects over time, if any, on your child's coronary arteries. Often, the disease's effects on the coronary arteries don't show up until the second or third week after the first symptoms appear. Therefore, this test is done regularly after the diagnosis.

Some children who don't have the classic signs and symptoms of the disease's acute phase may not be diagnosed until 2 to 3 weeks after the onset of the disease. This is when another common sign of Kawasaki disease occurs—peeling of the skin on the fingers and toes.

If your child is diagnosed at this point, he or she will likely need echocardiography right away to see whether the disease has affected the coronary arteries.

Other Diagnostic Tests

Doctors also use other tests to help diagnose Kawasaki disease. These include:

• Blood tests. These tests can show whether the body's blood vessels are inflamed.
• Chest x ray. This test can help show whether Kawasaki disease has affected the heart.
• EKG (electrocardiogram). This simple test detects and records the heart's electrical activity. EKG can show whether Kawasaki disease has affected the heart.