Kawasaki Disease or Incomplete Kawasaki Disease Clinical Pathway — Emergency Department and Inpatient
- 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.
Decision making for additional treatment is guided by:
- Response to treatment (fever, PE)
- Echocardiogram results (discuss with Cardiology)