Symptoms of Kawasaki disease

The symptoms of Kawasaki diseaseusually develop in three phases over a six-week period.

The three phases are described below.

Phase 1: acute (weeks 1-2)

Your child's symptoms will appear suddenly and may be severe.

High temperature

The first and most common symptom of Kawasaki disease is usually a high temperature (fever) of 38C (100.4F) or above.

The fevercan come on quickly anddoesn't respond to Penicillin or medicines typicallyused to reduce a fever, such as ibuprofen or paracetamol . If your child has a fever, they may be very irritable.

Your child'sfever will usually last for at least five days. However,itcan last for around 11 dayswithout the proper treatment . In some rare cases, the fever can last for as long as three to four weeks.

The fever may come and go,and your child's body temperature could possibly reach a high of 40C (104F).


Your child may havea blotchy, red rash on their skin. Itusually starts in the genital area before spreading to the torso, arms, legs and face.

The spots areusually red and raised, but there will not be any blistering.

They may also swell up and peel or bleed.

The inside of your child's mouth and throat may also be inflamed.Their tongue may bered, swollen and covered in small lumps, also known as "strawberry tongue".

Swollen lymph glands

If you gently feel your child's neck, you may be able to feel swollen lumps on one or both sides. The lumps could be swollen lymph glands.

Lymph glands are part of the immune system, the body's defence against infection. They may swell to over 1.5cm wide, feel firm and beslightly painful.

Phase 2: sub-acute (weeks 2-4)

During the sub-acute phase, your child's symptoms will become less severe but may last longer. The fever should subside, but your child may still be irritable and in considerable pain.

Symptoms during the second phaseof Kawasaki disease may include:

  • peeling skin onthe fingers and toes also sometimes on the palms of the hands or the soles of the feet
  • abdominal pain
  • vomiting
  • diarrhoea
  • urine that contains pus
  • feeling drowsy andlacking energy (lethargic)
  • headache
  • joint pain and swollen joints
  • yellowing of the skin and the whites of the eyes (jaundice)

It's during the second phase of Kawasaki disease that complications are more likely to develop, such as a coronary artery aneurysm, which is a bulge in one of the blood vessels that supply blood to the heart.

Phase 3: convalescent (weeks 4-6)

Your child will begin to recover during the third phase of Kawasaki disease, which is known as the convalescent phase.

Your child's symptoms should begin toimprove and all signs of the illness should eventually disappear. However,your child may still have a lack of energy and become easily tired during this time.

Occasionally, complications candevelop during the third phase of Kawasaki disease, but they're more likely to develop before this stage.

Content supplied by the NHS Website

Medically Reviewed by a doctor on 25 Nov 2016