Symptoms - Kawasaki disease

The symptoms of Kawasaki disease usually develop in 3 phases over a 6-week period.

Phase 1: acute (weeks 1 to 2)

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

High temperature

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

The fever can come on quickly and doesn't respond to antibiotics or medicines typically used to reduce a fever, such as ibuprofen or paracetamol.

Your child's fever will usually last for at least 5 days, but it can last for around 11 days without the proper treatment.

In some rare cases, the fever can last for as long as 3 to 4 weeks.

Your child's body temperature could possibly reach a high of 40C. 

Rash

Your child will almost always have a skin rash. This can vary in appearance from child to child.

Read more about skin rashes in children.

Hands and feet

The skin on your child's fingers or toes may become red or hard, and their hands and feet may swell up.

Your child may feel their hands and feet are tender and painful to touch or put weight on, so they may be reluctant to walk or crawl while these symptoms persist.

Conjunctival injection

Conjunctival injection is where the whites of the eyes become red and swollen. Both eyes are usually affected, but the condition isn't painful.

Unlike conjunctivitis, where the thin layer of cells that cover the white part of the eye (conjunctiva) becomes inflamed, fluid doesn't leak from the eyes in conjunctival injection.

Lips, mouth, throat and tongue

Your child's lips may be red, dry or cracked. 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 be red, 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 usually on one side. The lumps could be swollen lymph glands.

Read more about the complications of Kawasaki disease.

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

During the sub-acute phase, your child's symptoms will become less severe, but may last a while.

The fever should subside, but your child may still be irritable and in considerable pain.

Symptoms during the second phase of Kawasaki disease may include:

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

Phase 3: convalescent (weeks 4 to 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 to improve and all signs of the illness should eventually disappear.

But your child may still have a lack of energy and become easily tired during this time.

Page last reviewed: 26/07/2018
Next review due: 26/07/2021