Signs of Kawasaki Disease
Medically reviewed by Dr. Michael Okonkwo, MD, FAAP · Board-Certified Neonatologist
Content reviewed against published AAP, CDC, AAP guidelines
Last reviewed:
If your baby has been diagnosed with or you suspect signs of kawasaki disease, here is what the evidence says.
The short answer
Kawasaki disease is a rare illness that causes inflammation of blood vessels, most commonly in children under 5. Key signs include fever lasting 5+ days, rash, red eyes, swollen red lips or tongue, swollen hands/feet, and later peeling skin. It requires urgent medical treatment to prevent heart complications, so contact your pediatrician if your child has unexplained high fever for several days.
Key takeaways
- Kawasaki disease is a rare illness that causes inflammation of blood vessels, most commonly in children under 5. Key signs include fever lasting 5+ days, rash, red eyes, swollen red lips or tongue, swollen hands/feet, and later peeling skin. It requires urgent medical treatment to prevent heart complications, so contact your pediatrician if your child has unexplained high fever for several days.
- Usually normal when: Your child has a fever for 2-3 days with typical cold or flu symptoms
- Call your doctor if: Your child has had a high fever (over 101°F/38.3°C) for 5 or more days
- Varies by age — see the age-by-age breakdown below
“Fever itself is not an illness — rather, it is a sign or symptom that the body is fighting an infection. Fever stimulates certain defenses, such as the white blood cells, which attack and destroy invading bacteria.”
Parents everywhere have the same worry. You are doing the right thing by looking into it.
What Parents Should Know
According to AAP, CDC guidelines, kawasaki disease is a rare illness that causes inflammation of blood vessels, most commonly in children under 5. Key signs include fever lasting 5+ days, rash, red eyes, swollen red lips or tongue, swollen hands/feet, and later peeling skin. It requires urgent medical treatment to prevent heart complications, so contact your pediatrician if your child has unexplained high fever for several days. At 0-12 months, kawasaki disease is less common in babies under 1 year but can occur. Infants may have fever for 5+ days, extreme irritability, red eyes without discharge, swollen red lips, rash (often in the diaper area), and swollen hands or feet. Babies with Kawasaki disease are often very fussy and difficult to console. If your baby has unexplained high fever for more than 3-4 days, contact your pediatrician. It is generally considered normal when your child has a fever for 2-3 days with typical cold or flu symptoms. However, you should contact your pediatrician promptly if your child has had a high fever (over 101°F/38.3°C) for 5 or more days.
Normal vs. Concerning
When to Seek Immediate Care
- Your child has had a high fever (over 101°F/38.3°C) for 5 or more days
- Your child has fever plus multiple signs: red eyes, red/cracked lips, strawberry tongue, rash, or swollen red hands/feet
- Your child seems very unwell, is extremely irritable, or refuses to eat or drink
- Your child was treated for Kawasaki disease and develops new symptoms like chest pain or difficulty breathing
By Age
What to expect by age
0-12 months
Kawasaki disease is less common in babies under 1 year but can occur. Infants may have fever for 5+ days, extreme irritability, red eyes without discharge, swollen red lips, rash (often in the diaper area), and swollen hands or feet. Babies with Kawasaki disease are often very fussy and difficult to console. If your baby has unexplained high fever for more than 3-4 days, contact your pediatrician.
1-2 years
This is a common age for Kawasaki disease. Your toddler may have high fever (often 104°F or higher) that doesn't respond well to fever reducers and lasts at least 5 days. Other signs develop over several days: bloodshot eyes, bright red cracked lips, "strawberry tongue," rash on the body, and red swollen hands and feet. About 1-2 weeks after fever starts, skin may peel from fingers and toes.
2-5 years
Kawasaki disease is most common in this age group, especially in children of Asian or Pacific Islander descent. The illness has distinct phases: fever phase (5+ days) with rash, red eyes, mouth changes, and swollen extremities, followed by peeling skin phase. Some children also have joint pain, vomiting, or diarrhea. Prompt treatment with IV immunoglobulin is important to reduce heart complication risk.
5-8 years
Kawasaki disease is less common but still possible in older children. Symptoms are the same as in younger children. Because it's rarer at this age, diagnosis may be delayed. If your child has prolonged high fever and develops any combination of red eyes, mouth changes, rash, or swollen hands/feet, mention Kawasaki disease to your doctor.
8 years+
Kawasaki disease is rare in children over 8 but has been reported. Any child with unexplained fever lasting 5+ days should be evaluated. In older children, other causes of prolonged fever are more likely, but Kawasaki disease should be considered if classic features develop.
What to Tell Your Pediatrician
- Describe when you first noticed signs of kawasaki disease and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if your child has had a fever for 3-4 days with no clear source.
- Mention if your child has a rash and red eyes but fever has only been present 2-3 days.
- Bring a list of any questions or observations you want to discuss at the appointment.
What Should You Do?
When to take action
- Your child has a fever for 2-3 days with typical cold or flu symptoms
- Your child's eyes are red due to an obvious eye infection (pink eye with discharge)
- Your child has a viral rash that appears briefly and fades
- Your child's fever improves with fever reducer and they seem relatively well
- Your child has had a fever for 3-4 days with no clear source
- Your child has a rash and red eyes but fever has only been present 2-3 days
- You're worried about Kawasaki disease and want your pediatrician to evaluate
- Your child had Kawasaki disease in the past and you want to know about follow-up care
- Your child has had a high fever (over 101°F/38.3°C) for 5 or more days
- Your child has fever plus multiple signs: red eyes, red/cracked lips, strawberry tongue, rash, or swollen red hands/feet
- Your child seems very unwell, is extremely irritable, or refuses to eat or drink
- Your child was treated for Kawasaki disease and develops new symptoms like chest pain or difficulty breathing
What You Can Do at Home
- Keep track of when you notice signs of kawasaki disease — noting the time of day, duration, and any triggers can help your pediatrician.
- Remember that your child has a fever for 2-3 days with typical cold or flu symptoms — this is generally within the range of normal.
- At 0-12 months, focus on observation rather than intervention unless your pediatrician advises otherwise.
- Follow any care instructions from your pediatrician. Keep a written log of symptoms to bring to appointments.
- While monitoring at home, seek immediate care if your child has had a high fever (over 101°F/38.3°C) for 5 or more days.
Related Resources
Fever Decision Tree
Step-by-step guidance for evaluating your baby's fever by age and temperature.
Rash Decision Tree
Identify common rashes and determine when to seek care.
Month-by-Month Development
Detailed monthly development guides from birth through 24 months.
When to Call the Doctor
General guide on when to call the pediatrician, visit urgent care, or go to the ER.
Frequently asked questions
Is signs of kawasaki disease normal?
When should I call the doctor about signs of kawasaki disease?
When is signs of kawasaki disease normal?
What causes signs of kawasaki disease?
What should I mention to my pediatrician about signs of kawasaki disease?
Is signs of kawasaki disease normal at 0-12 months?
Is signs of kawasaki disease normal at 1-2 years?
Should I go to the ER for signs of kawasaki disease?
Does signs of kawasaki disease go away on its own?
References
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss Signs of Kawasaki Disease.
Things to mention
- Describe when you first noticed signs of kawasaki disease and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if your child has had a fever for 3-4 days with no clear source.
- Mention if your child has a rash and red eyes but fever has only been present 2-3 days.
- Bring a list of any questions or observations you want to discuss at the appointment.
Observations to share
- Your child has had a fever for 3-4 days with no clear source
- Your child has a rash and red eyes but fever has only been present 2-3 days
- You're worried about Kawasaki disease and want your pediatrician to evaluate
Urgent signs to report immediately
- Your child has had a high fever (over 101°F/38.3°C) for 5 or more days
- Your child has fever plus multiple signs: red eyes, red/cracked lips, strawberry tongue, rash, or swollen red hands/feet
- Your child seems very unwell, is extremely irritable, or refuses to eat or drink
My notes
From ismybabyalright.com — free, evidence-based baby health guides
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members
Related Resources
Bottom line
Most cases of signs of kawasaki disease are normal. Talk to your pediatrician if your child has had a high fever (over 101°f/38.3°c) for 5 or more days.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
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