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Atypical presentation of Kawasaki disease resembling a retropharyngeal abscess

Korean Journal of Pediatrics 2009;52(2):251-255.
Published online February 15, 2009.
Atypical presentation of Kawasaki disease resembling a retropharyngeal abscess
Eu Jin Kim, Young Su Lim, Ji Eun Yoon, Heon-Seok Han
Department of Pediatrics, Chungbuk National University, College of Medicine, Cheongju, Korea
인두후부의 농양과 유사하게 표현된 비전형적인 가와사끼병
김유진, 임영수, 윤지은, 한헌석
충북대학교 의과대학 소아과학교실
Heon-Seok Han, Email: hshan@chungbuk.ac.kr
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.
Key Words: Mucocutaneous lymph node syndrome, Retropharyngeal abscess

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