Kawasaki Disease or Incomplete Kawasaki Disease —Discharge — Clinical Pathway: Emergency, Inpatient

Kawasaki Disease or Incomplete Kawasaki Disease Clinical Pathway — Emergency Department and Inpatient

Discharge Instructions and Follow-up Plan

Please ensure that Kawasaki disease is listed as the principal problem and select recommended discharge orders/instructions in EPIC.
Aspirin (ASA)
  • Low-dose ASA should be continued until directed by Cardiology.
  • Patients with coronary abnormalities may require prolonged use of ASA.
  • Avoid NSAIDS while on ASA.
Steroids
If received Inpatient
  • 2-3 week oral prednisolone/prednisone taper after initial treatment.
  • Suggested taper:
  • 2mg/kg/day div BID x 5 days, 1 mg/kg/day div BID x 5 days, 0.5 mg/kg/day DAILY x 5 days.
Outpatient Follow-up
  • PCP
    • Follow up within 2-3 days.
  • Cardiology
    • Follow up with repeat echocardiogram in approximately two weeks. Significant coronary findings may require earlier follow-up and more frequent echocardiograms.
  • Rheumatology
    • Follow up in 1-2 weeks if received steroids, inpatient.
  • All appointments should be made before discharge, if possible.
Reasons to Return to ED
  • Parent/caregiver should check child's temperature daily for 1-2 weeks after discharge from the hospital.
  • If the temperature is > 38° C or if other symptoms of Kawasaki disease return before follow-up with Cardiology or Rheumatology, child should return to the ED.
Vaccines
  • No live vaccines x 11 months.
  • During flu season: flu shot prior to discharge if not already received.