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

Initial Treatment

  • Initial treatment for KD and incomplete KD include IVIG and ASA.
  • Infants ≤ 6 months and patients with dilation of the coronary arteries (z score ≥ 2.5) at presentation are at particularly high risk for developing coronary artery abnormalities and should start prednisolone as part of their initial treatment.
  • Treatment should be started as soon as possible after diagnosis, specifically within 10 days from onset of fever.
  • It is reasonable to give treatment after 10 days if fever persists with ongoing inflammation (elevated CRP or ESR).
  • Treatment should not be given beyond the 10th day in absence of fever, significant elevation of inflammatory markers, or coronary artery anomalies.
  • Consult Cardiology upon admission. Obtaining an echocardiogram should not delay initial treatment.
  • Consult Rheumatology for any patient who is started on steroids.

Treatment Links

Decision making for additional treatment is guided by:

  • Response to treatment (fever, PE)
  • AND
  • Echocardiogram results (discuss with Cardiology)