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
  • Fever > 38.0 or recurrence of KD symptoms before follow-up with Cardiology or Rheumatology
Vaccines
  • No live vaccines x 11 months
  • During flu season: flu shot prior to discharge if not already received
Patient/family education
  • KD PFE