Kawasaki Disease

Kawasaki disease (KD) is an acute, self-limited vasculitis of medium-sized arteries that occurs mainly in children younger than 5 years. It is the leading cause of acquired heart disease in children in Canada and other high-income countries. Its importance lies almost entirely in the coronary arteries: without treatment roughly 25% of children develop coronary artery aneurysms, and with intravenous immune globulin (IVIG) given within the first 10 days of fever the rate falls to about 4%. Giant aneurysms can thrombose or stenose and cause myocardial infarction or sudden death in childhood or decades later. For the entry-level Canadian nurse practitioner, KD sits at the intersection of three core competencies: recognizing a time-sensitive diagnosis in a febrile child who may present to a family practice, walk-in clinic, emergency department or remote nursing station; arranging urgent transfer to a paediatric centre for treatment; and providing longitudinal primary care afterward, including medication safety, immunization timing and cardiovascular risk management across the lifespan. IVIG initiation is a paediatric hospital intervention; the NP's contribution is early suspicion, a focused work-up that does not delay referral,...