Risa Tona1, Shogo Shinohara2, Keizo Fujiwara2, Masahiro Kikuchi2, Yuji Kanazawa2, Ippei Kishimoto2, Hiroyuki Harada2, Yasushi Naito3. 1. Department of Otolaryngology, Kobe City Medical Center General Hospital, Japan; Department of Otolaryngology, Institute of Biomedical Research and Innovation, Japan. Electronic address: kurihara@fbri.org. 2. Department of Otolaryngology, Kobe City Medical Center General Hospital, Japan. 3. Department of Otolaryngology, Kobe City Medical Center General Hospital, Japan; Department of Otolaryngology, Institute of Biomedical Research and Innovation, Japan.
Abstract
OBJECTIVE: Kawasaki disease (KD) is an acute multisystemic vasculitis of unknown etiology that occurs in infants and children. Retropharyngeal cellulitis has been reported as a rare manifestation of KD. This study investigated the frequency and characteristics of patients with KD manifesting as retropharyngeal soft-tissue swelling. METHODS: We retrospectively reviewed 277 patients, with a mean age of 1 year and an age range of 7 months to 12 years, in whom KD had been diagnosed between 2005 and 2011. RESULTS: In 10 patients (3.6%), contrast-enhanced computed tomography (CECT) showed low-density lesions without ring enhancement in the retropharyngeal spaces. These patients presented initially with fever and cervical lymphadenopathy, and were initially treated by their pediatricians for suppurative lymphadenitis (seven patients) or retropharyngeal abscess (three patients). KD was finally diagnosed either after antibiotics had been ineffective or when other symptoms characteristic of KD emerged. CONCLUSION: Low-density lesions in the retropharyngeal space were identified by CECT in 3.6% of the KD patients. Early diagnosis of KD is essential because coronary artery lesions develop in 50% of untreated patients. If a child presents with fever, cervical lymphadenopathy, and swelling of the retropharyngeal space, KD should be included in the differential diagnoses.
OBJECTIVE:Kawasaki disease (KD) is an acute multisystemic vasculitis of unknown etiology that occurs in infants and children. Retropharyngeal cellulitis has been reported as a rare manifestation of KD. This study investigated the frequency and characteristics of patients with KD manifesting as retropharyngeal soft-tissue swelling. METHODS: We retrospectively reviewed 277 patients, with a mean age of 1 year and an age range of 7 months to 12 years, in whom KD had been diagnosed between 2005 and 2011. RESULTS: In 10 patients (3.6%), contrast-enhanced computed tomography (CECT) showed low-density lesions without ring enhancement in the retropharyngeal spaces. These patients presented initially with fever and cervical lymphadenopathy, and were initially treated by their pediatricians for suppurative lymphadenitis (seven patients) or retropharyngeal abscess (three patients). KD was finally diagnosed either after antibiotics had been ineffective or when other symptoms characteristic of KD emerged. CONCLUSION: Low-density lesions in the retropharyngeal space were identified by CECT in 3.6% of the KD patients. Early diagnosis of KD is essential because coronary artery lesions develop in 50% of untreated patients. If a child presents with fever, cervical lymphadenopathy, and swelling of the retropharyngeal space, KD should be included in the differential diagnoses.
Authors: Sooyeon Lim; Na Young Lee; Seung Beom Han; Dae Chul Jeong; Jin Han Kang Journal: Clin Exp Otorhinolaryngol Date: 2019-10-11 Impact factor: 3.372