Could this be Kawasaki?

[Worriedmum1994]

Hello!

I’ve just made an account whilst I wait for the doctor to call me back but wondered if anyone can offer me any peace of mind.

My 4 year old son had a fever 2 weeks ago, lasting around 3/4 days and it was controllable with calpol etc just persistent. No other symptoms at the time which I thought was strange, but then once the fever stopped he developed a couple of blotches for a few days on his skin. We took him to the out of hours as we suspected scarlet fever (the rash was barely noticeable once we got there) and they checked his obs, no fever present and said it was viral.

That was all roughly 10 days ago and his been fine since, but last night I went in to check on him at bedtime and he was peeling skin pretty badly on his fingers, literally pulling it off in chunks. I checked his feet which have very minor peeling and did a quick google which naturally came up with Kawasaki and has freaked me out.

I’ve read every page on the internet and every mumsnet thread so far on it and can’t seem to find anything conclusive as he didn’t have the 5 day uncontrolled temp as has been fine in between but the shedding is weird. His lips were a little dry and cracked this morning so I’ve called the doctors and I’m back to freaking out again.

I just wondered whether anyone can shed any light? If it was Kawasaki would it have been more noticeable over the last week or so? We’ve had half term and he’s been his usual self, no fever or symptoms but I know that doesn’t mean it can’t be it it, or does it?

Thanks!

He’d be far more poorly in my opinion if it was Kawasaki and it’s very rare. My friend took her little one to gp worried he had
it and the gp said in her entire career they’ve never seen a case and he had far more symptoms
than your one.
my DD had scarlet fever recently and had the skin peeling thing a few days after her rash faded. It’s another symptom of it along with fever followed by rash. Sounds more likely to be that to be honest. Not all kids need antibiotics to recover from scarlet fever so could easily have been dismissed as viral at the time of presenting at a&e especially if the rash wasn’t too severe.

My son was misdiagnosed with scarlett fever but it was Kawasaki disease. At that time, 20 years ago, you had to tick five symptom boxes to be diagnosed, he ticked three. It was diagnosed retrospectively after a heart echo picked up bulky arteries. The peeling in my son was not at the same time as he had a 5 day fever. It was a couple of weeks after.

It is becoming more common but is still relatively rare.
Sue is very helpful and there is a helpline https://www.societi.org.uk/kssg/

They do tend to be very cranky and grumpy afterwards for a few weeks.It is something that really stuck out with my son as he was a very laid back toddler.
I

My DS had KD. He was very very poorly. He couldn’t move for 2 weeks, was sick, very very pale. I have 3 children and have never seen a pale / grey like it. I hope this reassures you.

Just to add to this thread for anyone googling, we have experience of probable KD (they can never diagnose 100% ) and it's really terrible, we knew nothing about it but we were concerned from about day 2 went to the GP on about day 3 and a&e on about day 5 at which point it was identified quickly and the child was admitted for treatment.

The general rule with kids and babies seems to be that they always want to assess children if the parents are concerned rather than see them too late. We persisted with 111 every time we were concerned.

Apparently Kawasaki is more common since COVID, and awareness is much higher. The doctor in the ward said they have treated this condition many times now over their career.

Was your little one very unwell. I’ve been worrying over this. Day 4 of a fever but seems happier and eaten a little more than recent today but I just can’t get this out of my head x

@johnd2 and @GoodStuffAnnie

Phone 111 if any concerns.
Check whites of eyes and look for any rash, is fever over 38/39?
The infectious diseases team at great ormond street said they only see 2 or 3 cases a year ago it's very rare, so rare that my child was treated for sepsis and strep b at the same time as they are far more common.
My child seemed to get a little better and a little worse but fever didn't really drop and was never well enough to get up (or even lift his head by day 4/5.) We took him to a&e when he started refusing fluids

Oh yeah and just to add @Fightingtobepositive his lips basically peeled off like a sheet on about day 4, was like a snake skin almost although quite a few pieces. I thought it was from the vomiting but it's a warning sign

thank you for responding. I hope he’s ok now ❤️

well the eyes are what started my worry off. He had red eyes and temp spiked to 40 on Thursday (the first day of temp) took him to a&e and said conjunctivitis and ears no else and throat probably viral but gave antibiotics. Yesterday he was unwell didn’t eat much and slept a lot. Today the red eyes have gone and he seems brighter he’s been happy and playing not slept and eaten some food. His temp is still rising after the meds run out but staying around 37s after we’ve give it. He does generally seem a bit better today. But I can’t get the redness in his eyes out of my mind (gone now) also he has sligtt he lay swollen neck which I’m guessing is his lymph nodes, I guess that would happen with a throat infection but it’s just worrying me. I’m an anxious person anyway. I worry so much about him.

@johnd2

Just phone 111 (or go to A&E). You know him best. In my experience they are always happy to check out a sick child.
Was the eye redness with or without discharge/soreness/itchyness? The key thing they kept asking me was about any discharge or discomfort, and there was none at all in our case, just even redness all over the white area both sides.
In our case the GP thought it was some kind of throat or ear infection with no clear symptom but super high temperature (on day 3, eyes were not red at that stage but temp was >40c), but once we got to A&E on day 5 they realised almost straight away and admitted him for treatment. Apparently his was quite a clear/text book case though.
Tell them you are concerned about Kawasaki (there's a related thing called PIMS-TS but according to the doctor in the infectious diseases team at GOSH, they don't really see cases of that any more).

@johnd2 well no discharge really. But having said that the day after he did wake up with a slight bit of crustiness in the one eye (both slightly bloodshot). That was the day after temp started. The red eyes came the same day as the temp. Temp
and red eyes Thurs day red eyes Fri still temp and swollen neck (maybe glands) today but red eyes have gone. Temp still there when calpol stops but does respond to bride and calpol. He’s seemed to have improved today. Playing more energy and has eaten something.

I'm not a doctor, you're not a doctor, but if you're concerned trust yourself and then get them to a doctor or call 111.
Having said that if you're only on the 3rd day of fever, NHS and gosh says you should be on day 5 ideally to consider Kawasaki disease and ideally you should start treatment on or before day 7. So you don't have as much rush at this stage.
But let it be known that even with loads of doctors checking my child, including calling with specialist diseases doctors at Gosh and doing all sorts of tests and scans, even they had to treat for various other serious illnesses because they couldn't be sure. So there's no chance of a clear diagnosis from googling and asking on here.
Your job as a parent is to get medical assessment when you are concerned, and it's for the doctors to decide on diagnosis and treatment, so focus on your job.
Good luck!

@johnd2 thank you for your responses. We are today home from hospital. I mention KD and after hearing his symptoms they had already thought of it. We were admitted. He showed most of the symptoms by Sunday. They did bloods and heart scan which were normal apart from crp which were only slightly raised. The doctor was very thourough and so torn on what to do for the best because as we know there’s no one specific test. But she came today and seen my little on on his feet and playing and gave him another check over and said she’s slightly swaying away from KD because he’s improved slightly, his scan was ok and his platelet count was normal. But she did reiterate that she can’t be sure and if we wanted to go ahead she would support us. But from her side she is slightly swaying to a nasty virus.

he had symptoms cracked lips but no strawberry tounge. Wouldn’t walk for an entire day but no swollen hands and feet. I’m obviously still a bag of nerves wondering if the right decision has been made. Any information on the tests etc done would be so appreciated ❤️

@Fightingtobepositive that sounds like good news, since Kawasaki is their immune system attacking the blood vessels the crP would be really high, they said our child's was 230 and even if you are quite ill with an infection that would only go over 40. It took 6 days to go under 20 which allowed us to be discharged to go home and then another 2 days to be below 10 which is basically enough to stop monitoring.
There was also another inflammation marker that was over 1000 which is also very high.
The issue they said is the crP just tells them there's a massive immune response going on, but it doesn't rule out things like sepsis.
If your crp is low then that suggests the immune system isn't really busy at the moment/any more.
Also on his feet is a good sign, our little one couldn't even lift his head for 3/4 days, and took a couple more to get out of bed and play. And that was after vast amounts of medicine etc to help him.
So from what I know it sounds like not Kawasaki thank goodness, but that doesn't make it any less worrying to have an ill child!

@johnd2 thank you so much for your reply it means a lot. It must have all been so traumatic for you. His crp was 25 the rest normal. He was bed bound for two days but then started to get up and have a little play although wobbly and tiring very fast. He has had so many of the KD symptoms over the last 10 days it’s so hard to get out of my head. What day did your little one get diagnosed? Did he just get more poorly as time went on? I guess I have to take some comfort in th heart scan being ok to.

they can never diagnose 100% but they said they are treating for that on day 5 and had the ivig across day 6/7 plus 2 different iv antibiotics in case it was something else. He was getting worse up until I think the end of day 7 and on day 8 they started IV steroids and he started to get better. They were being careful not to treat unnecessarily because there's a risk of side effects of any treatment.
I think if you have been checked out at hospital and have flagged kawasaki then I would say consider other things. We were googling and seeing things online, and when we asked questions about it, it turned out the doctors were already in touch with the team that was writing the papers and information we were looking at online, so they knew everything for sure.
Our follow up appointments are with that team directly and they bascially said his case is so classic based on symptoms, progression and test results, so they are very sure of the diagnosis.

@johnd2 thank you for responding. These kids are such a worry aren’t they. I am anxious about health anyway so I’m probably over thinking everything. He’s still not back to his busy cheeky self but much better than he’s been. So I guess I have to accept it at this point and hope it wasn’t KD and just a nasty virus 🙏🤞