Peritonsillar abscess – an unusual presentation of Kawasaki disease

Abstract

Kawasaki disease (KD) is a paediatric illness characterised by prolonged high fever, mucocutaneous lesions and lymphadenopathy. It is potentially fatal as coronary arteritis occurs in up to a third of affected children. We present a seven-year-old child who was admitted to hospital with neck pain and fever. Despite intravenous antibiotic therapy and a quinsy right tonsillectomy on the sixth day after admission, the patient's symptoms persisted. With the appearance of further signs and symptoms the diagnosis of KD was made two days after operation. The patient's symptoms resolved with aspirin and intravenous gammaglobulin therapy. A literature review of the various aspects of KD is presented.

Retropharyngeal Edema: An Unusual Manifestation of Kawasaki Disease

“…Review of the literature suggests that KD can occasionally present initially with a clinical and radiographic picture concerning for deep neck bacterial infection such as cervical adenitis, retropharyngeal, parapharyngeal, or peritonsillar abscess (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). Other unusual otolaryngologic abnormalities reported rarely in KD include necrotic pharyngitis, severe uvulitis, and supraglottitis (15,16).…”

Kawasaki disease resembling a retropharyngeal abscess — Case report and literature review

“…Additionally, KD may present with symptoms like other kinds of deep neck infections, such as a peritonsillar abscess, [11,12] peritonsillar or deep neck cellulitis, [13] suppurative parapharyngeal space infection, [14] or retropharyngeal cellulitis or mass [15][16][17][18]. Although KD mimicking a deep neck infection appears to be rare, the true incidence of a retropharyngeal pathology is unknown due to the general lack of routine neck imaging.…”

Kawasaki Disease Mimicking a Parapharyngeal Abscess

“…The rarity of these presentations often leads to missed or delayed diagnosis and treatment. 4 – 6 In this patient, although infection cannot be ruled out at the early stage, the fact that blood and throat cultures were negative and there was an excellent response within 24 hours after administration of intravenous immunoglobulin (IVIG) and aspirin makes the diagnosis of KD presenting as a parapharyngeal abscess-like lesion more plausible than an infection coexisting with KD.…”