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http://dx.doi.org/10.3345/kjp.2009.52.2.251

Atypical presentation of Kawasaki disease resembling a retropharyngeal abscess  

Kim, Eu Jin (Department of Pediatrics, Chungbuk National University, College of Medicine)
Lim, Young Su (Department of Pediatrics, Chungbuk National University, College of Medicine)
Yoon, Ji Eun (Department of Pediatrics, Chungbuk National University, College of Medicine)
Han, Heon-Seok (Department of Pediatrics, Chungbuk National University, College of Medicine)
Publication Information
Clinical and Experimental Pediatrics / v.52, no.2, 2009 , pp. 251-255 More about this Journal
Abstract
Kawasaki disease is an acute systemic inflammatory disorder, the etiology of which has not yet been established. The clinical manifestations are non-specific and are common to many pediatric infectious and immunologic diseases. In 2 cases presenting fever, cervical lymphadenopathy, and retropharyngeal abscess-like lesions on the neck shown in a computerized tomography (CT) scan, the diagnosis of Kawasaki disease was delayed. The patients were not responsive to antibiotic therapy, and fluid collection was not found during retropharyngeal aspiration. They showed typical Kawasaki manifestations over time and atrioventricular valve regurgitation in the echocardiogram. A diagnosis of Kawasaki disease should be considered in similar cases of fever and cervical lymphadenopathy. A CT scan that shows a retropharyngeal abscess-like lesion on the neck can be a false positive finding, and other laboratory exams, including echocardiography, should be performed as early as possible to avoid unnecessary medical and surgical procedures.
Keywords
Mucocutaneous lymph node syndrome; Retropharyngeal abscess;
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1 Park AH, Batchra N, Rowley A, Hotaling A. Patterns of Kawasaki syndrome presentation. Int J Pediatr Otorhinolaryngol 1997;40:41-50   DOI   ScienceOn
2 Hung MC, Wo KG, Hwang B, Lee PC, Meng CC. Kawasaki disease resembling a retropharyngeal abscess case report and literature review. Int J Cardiol 2007;115:e94-96   DOI   ScienceOn
3 Newburger JW, Fulton DR. Kawasaki disease. Curr Treat Options Cardiovasc Med 2007;9:148-58   DOI   ScienceOn
4 Taubert KA, Rowley AH, Shulman ST. Seven-year national survey of Kawasaki disease and acute rheumatic fever. Pediatr Infect Dis J 1994;14:823-4   DOI
5 Anderson MS, Todd JK, Glode MP. Delayed diagnosis of Kawasaki syndrome: an analysis of the problem. Pediatrics 2005;115:e428-33   DOI   PUBMED   ScienceOn
6 Joffe A, Kabani A, Jadavji T. Atypical and complicated Kawasaki disease in infants. Do we need criteria? West J Med 1995;162:322-7   PUBMED   ScienceOn
7 Hathursinghe HR, Patel S, Uppal HS, Ray J. Acute tonsillitis: an unusual presentation of Kawasaki syndrome: a case report and review of the literature. Eur Arch Otorhinolaryngol 2006;263:336-8   DOI   ScienceOn
8 Yoskovitch A, Tewfik TL, Duffy CM, Moroz B. Head and Neck manifestations of Kawasaki disease. Int J Pediatr Otorhinolaryngol 2000;52:123-9   DOI   ScienceOn
9 Chakrabartty S, Pramanik S, Thapa R. Difficulties in the diagnosis of Kawasaki disease. Indian Pediatr 2006;43:728-31   PUBMED
10 McLaughlin RB Jr, Keller JL, Wetmore RF, Tom LW. Kawasaki disease: a diagnostic dilemma. Am J Otolaryngol 1988;19:274-7   DOI   ScienceOn
11 Mishra K, Choudhury J. Kawasaki disease: Is atypical more common than typical. Indian Pediatr 2006;43:453-4
12 Gross M, Elisashar R, Attal P, Sichel JY. Radiology quiz case 2: Kawasaki disease (KD) mimicking a retropharyngeal abscess. Arch Otolaryngol Head Neck Surg 2001;127:1507-9   PUBMED   ScienceOn
13 Homicz MR, Carvalho D, Kearns DB, Edmonds J. An atypical presentation of Kawasaki disease resembling a retropharyngeal abscess. Int J Pediatr Otorhinolaryngol 2000;54:45-9   DOI   ScienceOn
14 Han RK, Sinclair B, Newman A, Silverman ED, Taylor GW, Walsh P, McCrindle BW. Recognition and management of Kawasaki disease. CMAJ 2000;162:807-12   ScienceOn
15 Newburger JW. Kawasaki disease. Curr Treat Options Cardiovasc Med 2000;2:227-36   DOI   PUBMED   ScienceOn
16 Weiss JE, Eberhard BA, Chowdhury D, Gottieb BS. Infliximab as a novel therapy for refractory Kawasaki disease. J Rheumatol 2004;31:808-10   PUBMED