Q: My child developed a full-body rash two days after discharge for Kawasaki disease treatment. There is no fever, only the rash. Should we go to the ER?

Medically reviewed by Sang Hyun Ahn, MD

Content edited by Myeongchan Kim, MD

This post is a dramatization of a question and answer session experienced by our actual medical reviewers. Please note that this content is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.

Question:

My child was discharged two days ago after receiving treatment for Kawasaki disease. This morning, a rash broke out all over their body. There is no fever (temperature is around 37.4°C), just the rash. Is this a situation where we need to rush to the emergency room?

Answer:

It is completely understandable to be worried when a rash appears shortly after treating Kawasaki disease.

There are several possible reasons for a rash to develop after Kawasaki disease treatment. These include:

• A reaction to IVIG (Intravenous Immunoglobulin) treatment, which is common and usually benign.

• A side effect of aspirin.

• A part of the normal recovery process of Kawasaki disease.

• A new, unrelated viral infection.

Without a physical examination, it is difficult to determine the exact cause of the rash. However, you should take your child to the Emergency Room immediately if you observe any of the following warning signs:

• Difficulty breathing.

• Swelling of the face or lips.

• A rash that spreads very rapidly.

• A hemorrhagic rash (red or purple spots that do not fade or turn white when you press on them).

• A new fever of 38°C (100.4°F) or higher.

Since your child currently has no fever and their general condition appears stable, an immediate trip to the ER may not be necessary. However, because of their recent hospitalization, it is highly recommended that you visit your pediatrician or an outpatient clinic today for a proper clinical evaluation.

If possible, contact your pediatric cardiologist's office for advice first. When you go to the doctor, be sure to bring a list of all medications prescribed at discharge and take clear photos of the rash in case its appearance changes before your appointment.

For extra peace of mind and clear guidance when tracking your child's symptoms, the FeverCoach app is always there to help.

https://fevercoach.us