Acute tonsillitis: an unusual presentation of Kawasaki syndrome: a case report and review of the literature.

Kawasaki syndrome is an acute, self-limiting vasculitis that occurs mainly in children. The disorder is difficult to diagnose, a problem compounded by the lack of a specific diagnostic test. If the condition is unrecognised or treated sub-optimally, there is a 25% risk of developing serious cardiovascular complications. We report the case of an 8-year-old boy presenting with a history of acute tonsillitis and cervical lymphadenopathy in which the diagnosis of Kawasaki syndrome became apparent 4 days after admission. The case emphasises the importance of having a high index of suspicion for Kawasaki syndrome in children presenting with tonsillitis and cervical lymphadenopathy who do not respond to antibiotics or who have atypical features at the time of or after admission. A literature review of previous cases reveals a higher than usual age of presentation for the disease that could result in a greater percentage of cardiac complications.