Kawasaki disease mimicking retropharyngeal abscess

Pontell, Jonathan; Rm, Rosenfeld; Kohn, Barbara

doi:10.1177/019459989411000413

Cited by 37 publications

(7 citation statements)

References 6 publications

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“…The main finding was retropharyngeal low density without rim enhancement; examples include a retropharyngeal abscess, retropharyngeal cellulitis, and retropharyngeal edema (3-10). Langley et al (10) reported a case of Kawasaki disease and previously reported sporadic cases, and found that the 11 cases of retropharyngeal low density did not respond to antibiotics and confirmed sterile conditions in the surgical drainage (3, 5, 7, 9). After treatment with immunoglobulin under the diagnosis of Kawasaki disease, all patients showed clinical improvement (3-10).…”

Section: Discussionmentioning

confidence: 91%

CT Analysis of Retropharyngeal Abnormality in Kawasaki Disease

2011

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ObjectiveTo retrospectively compare the imaging characteristics of retropharyngeal density and associated findings for Kawasaki disease with those for non-Kawasaki disease, and identify the distinguishing features which aid the CT diagnosis of Kawasaki disease with retropharyngeal low density.Materials and MethodsAmong the enhanced neck CT performed in children less than 8-years old with clinical presentation of fever and cervical lymphadenopathy over a 6-year period, only cases with retropharyngeal low density (RLD) were included in this study. The 56 cases of RLD were divided into two groups; group A included cases diagnosed as Kawasaki disease (n = 34) and group B included cases diagnosed as non-Kawasaki disease (n = 22). We evaluated the CT features including the thickness of RLD and its extent into the deep neck spaces, as well as soft tissue change in the adjacent structure. We also scored the extent of RLD into the deep neck spaces and the soft tissue changes in the adjacent structure.ResultsThe thickness of RLD was greater in group A than in group B (group A, 6.0 ± 2.1; group B, 4.6 ± 1.5, p = 0.01). The score of the RLD extent into the deep neck spaces was significantly greater in group A than in group B (group A, 2.3 ± 1.3; group B, 0.8 ± 1.0, p < 0.01). Also, the score of the adjacent soft tissue changes was greater in group A than in group B (group A, 2.0 ± 1.1; group B, 1.0 ± 1.0, p < 0.01).ConclusionIf children present with fever and cervical lymphadenopathy that display retropharyngeal low density with extension into more deep neck spaces as well as changes in more adjacent soft tissue, the possibility of Kawasaki disease should be considered.

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Section: Discussionmentioning

confidence: 91%

CT Analysis of Retropharyngeal Abnormality in Kawasaki Disease

2011

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“…A Medline search revealed at least six reported cases of KD with an initial diagnosis of a retropharyngeal abscess1-6). Symptoms of all the patients in thoses cases improved dramatically, including their cervical adenopathy after IVIG infusion.…”

Section: Discussionmentioning

confidence: 99%

“…Head and neck manifestation of KD includes cervical lymphadenitis, parotitis, otitis media, epiglottitis, peritonsillar abscess, or peritonsillar cellulitis and less commonly retropharyngeal abscess (RPA). There have been several reports in English on KD with RPA since 19941-6). Needle aspirations from these patients established the nonsuppurative nature of the illness.…”

Section: Introductionmentioning

confidence: 95%

A case of Kawasaki disease with coexistence of a parapharyngeal abscess requiring incision and drainage

Choi

Kim

2010

Korean J Pediatr

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Kawasaki disease (KD) causes multisystemic vasculitis but infrequently manifests with deep neck infections, such as a peritonsillar abscess, peritonsillar or deep neck cellulitis, suppurative parapharyngeal infection, or retropharyngeal abscess. As its etiology is still unknown, the diagnosis is usually made based on typical symptoms. The differential diagnosis between KD and deep neck infections is important, considering the variable head and neck manifestations of KD. There are several reports on KD patients who were initially diagnosed with retropharyngeal abscess on on computed tomography scans (CT). However, the previously reported cases did not have abscess or fluid collection on retropharyngeal aspiration. Therefore, false-positive neck CT scans have been obtained, until recently. In this case, suspected neck abscess in patients with KD unresponsive to intravenous immunoglobulin could signal the possible coexistence of suppurative cervical lymphadenitis.

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“…In the present case, all other previously known causes of retropharyngeal edema were ruled out, and this condition was attributed to KD. A review of the English-language literature indicated that this complication, which is generally diagnosed based on CT findings, was first described by Pontell et al in 1994 ( 6 ). Subsequently, the details of similar cases were presented sporadically as case reports.…”

Section: Discussionmentioning

confidence: 99%

Adult Recurrence of Kawasaki Disease Mimicking Retropharyngeal Abscess

et al. 2017

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Kawasaki disease (KD) is an acute, self-limited vasculitis of unknown etiology that occurs predominantly in young children (≤5 years of age). We herein report the case of an 18-year-old Japanese man with a history of incomplete KD during infancy; later, despite an initial diagnosis of retropharyngeal abscess, he was ultimately diagnosed with retropharyngeal edema associated with recurrent KD. Adult-onset or recurrent KD is an uncommon event, and retropharyngeal edema is a rare manifestation of this disease. Internists should be aware of the possibility of KD that mimics a retropharyngeal abscess, even in adult patients.

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Kawasaki disease mimicking retropharyngeal abscess

Cited by 37 publications

References 6 publications

CT Analysis of Retropharyngeal Abnormality in Kawasaki Disease

CT Analysis of Retropharyngeal Abnormality in Kawasaki Disease

A case of Kawasaki disease with coexistence of a parapharyngeal abscess requiring incision and drainage

Adult Recurrence of Kawasaki Disease Mimicking Retropharyngeal Abscess

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