Kawasaki Disease

Kawasaki disease (KD) is an acute systemic vasculitis of small- and medium-sized arteries that mainly affects young children. It is a leading cause of acquired heart disease in childhood because the inflammation can involve the coronary arteries. Cause and transmission: the exact cause is unknown. Genetic susceptibility appears to play a role, and a viral or bacterial infection may trigger the illness in a susceptible child. KD is not contagious and does not spread from child to child; any infection the child also has is managed with the precautions that infection needs. Mechanism, in nursing terms: an intense systemic inflammatory response produces persistent fever, a raised C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), and inflammation of the eyes, mouth, skin, hands and feet, and cervical lymph nodes. Inflammation of the coronary artery wall can weaken it, so the vessel dilates or forms an aneurysm. Aneurysms may develop up to 4 to 6 weeks after the illness begins, which is why a child who looks well once the fever settles still needs repeat echocardiography. Blood moves slowly through an aneurysm...