What are the five common types of Kawasaki disease?

Nowadays, some people do not take minor health problems seriously at all. It is too late when the minor problems become big problems. Not only do they spend more money, but the patients themselves also suffer. As the saying goes, taking care of an illness is like raising a tiger. Take Kawasaki disease for example. It was treated as a minor cold at the beginning. By the time you find out it is Kawasaki disease, the condition has become serious. The following are the five common types of Kawasaki disease.

1. Sudden fever, presenting as remittent fever or persistent fever, lasting for 5 to 11 days or longer (2 weeks to 1 month), with an average body temperature often reaching above 39°C, and antibiotic treatment is ineffective. Common bilateral conjunctival congestion, lip flushing, cracking or bleeding, and bayberry-like tongue are seen. About 1 to 4 days after the fever, polymorphic red macules appear on the trunk, especially the perineum, and may also present as urticaria-like rashes, with itching, but no blisters or scabs. After 1 week, the proximal ends of the fingernails or toenails become pale, and there is hard edema in the hands. The palms and soles of the feet become flushed early, and the skin is often tight and hard, without depression when pressed. After 10 days, characteristic large-scale peeling of the toes appears at the junction of the nail bed and skin. About 2 months later, transverse grooves often appear on the fingernails and toenails. The course of the disease is often accompanied by acute, non-purulent, transient cervical lymph node swelling, which is most obvious in the front of the neck, with a diameter of more than 1.5 cm, mostly appearing on one side, with slight tenderness, occurring within 3 days after fever, and healing on its own after a few days.

2. About 10 days after the onset of fever, when the rash, fever and other acute symptoms begin to subside, heart damage often occurs, and symptoms such as acute myocarditis, pericarditis, endocarditis, and arrhythmia occur. The patient is pale, cyanotic, weak, chest tightness, and precordial pain. Systolic murmurs, tachycardia, gallop rhythm, and dull heart sounds can be heard during auscultation. Cardiac damage is found in about 50% of cases through clinical, electrocardiographic, echocardiographic, and radiographic examinations. Echocardiography and coronary angiography can show that most patients have coronary artery aneurysms, pericardial effusions, left ventricular enlargement, and mitral valve regurgitation. X-ray chest films can show enlarged heart shadows. Coronary artery aneurysms with a diameter of less than 8mm can retract; those with a diameter of more than 8mm cannot retract, and are prone to coronary stenosis or occlusion, causing myocardial infarction.

3. The main symptoms are arthritis or joint swelling and pain, iridopathitis, otitis media, pneumonia, aseptic meningitis, abdominal pain and diarrhea, mild jaundice or aseptic cerebrospinal meningitis. A small number of patients have hepatitis, gallbladder edema, intestinal paralysis and intestinal bleeding, pleural effusion, cranial nerve paralysis and encephalopathy. In the acute phase, about 20% of cases have perineum and perianal skin flushing and peeling, and erythema or scab reappears at the original site of BCG vaccination 1 to 3 years ago. Horizontal grooves can be seen on the nails during the recovery phase.

4. Generally, the duration of fever is short-term, which is four or five days. Some patients may have a longer fever, which may last for one or two weeks. Some patients will have redness and swelling on their faces after fever, which is often called facial swelling. Some patients will also have maculopapular rashes of different sizes on their bodies. Some patients will have dry and cracked lips, and some patients may even have symptoms of bleeding in the oral mucosa.

5. Some patients will have a bayberry tongue, and some patients will have symptoms of mucosal congestion in the mouth, but no ulcers. When the patient has a fever and a rash appears on the eyes, lips and the patient, it can be diagnosed as Kawasaki disease. If a child is diagnosed with Kawasaki disease, he or she needs to go to the hospital immediately.

Kawasaki disease is a very long-term disease and can occur all year round, but it may be more common in winter and spring. Kawasaki disease usually causes fever at the beginning and looks similar to the common cold, but in fact the symptoms are different. Parents and friends will be able to tell the difference apart as long as they pay more attention.