The initial symptoms of Kawasaki disease are similar to many other infections or allergic reactions.

The first symptom usually is a sudden, high fever that may be 104F or higher. Unlike fever caused by common viruses, the fever from Kawasaki disease can last more than 10 days if the disease is not treated.

Other symptoms often occur within a few days after the fever. These symptoms include:

• Red, bloodshot eyes, usually without pus or discharge.
• A red body rash that varies in size, shape, and consistency. The rash rarely blisters and is usually most obvious in the torso or groin area.
• Red, swollen, cracked lips and a red ("strawberry") tongue and lining of the mouth.
• Firm, swollen hands and feet with shiny red palms and soles. The skin begins to shed and peel between 1 and 3 weeks after the fever starts. Peeling starts beneath the fingernails and toenails and slowly spreads to the palms and soles.
• Swelling of lymph nodes on one side of the neck. Swelling very rarely occurs on both sides of the neck.

Other symptoms may include:

• Irritability and tiredness.
• Joint swelling and pain. The pain sometimes is very severe; a child may refuse to move or put weight on his or her hands and feet.
• Abdominal pain, vomiting, and diarrhea.
• A rapid heart rate or changes in heart rhythm from heart inflammation.

Other conditions have symptoms similar to Kawasaki disease, including measles, Epstein-Barr infections, scarlet fever, drug reactions, toxic shock syndrome, and juvenile rheumatoid arthritis. It is important for a child with symptoms to see a health professional for diagnosis and proper treatment.